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General NPI Number Information
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NPI Number | 1457465585
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Entity Type | Individual
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Provider Name | MARIA MERCEDES CABODEVILLA-CONN MD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 230 WESTCHESTER AVE
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City | WEST HARRISON
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State | NY
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Zip | 10604-2917
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Country | US
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Telephone | 914-684-6113
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Fax | 914-684-2740
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Provider Business Mailing Address
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Address Line | 2900 WESTCHESTER AVE SUITE 307
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City | PURCHASE
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State | NY
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Zip | 10577-2552
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Country | US
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Telephone | 914-249-7000
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Fax | 914-249-7032
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine
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License Number | 214095
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License Number State | NY
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