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General NPI Number Information
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NPI Number | 1457650970
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Entity Type | Organization
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Legal Business Name | OLAF HAROLDSON, MD, PC
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 7 CENTRE DR SUITE 12
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-1565
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Country | US
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Telephone | 609-655-5505
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Fax | 609-655-5521
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Provider Business Mailing Address
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Address Line | 7 CENTRE DR SUITE 12
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-1565
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Country | US
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Telephone | 609-655-5505
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Fax | 609-655-5521
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Authorized Official
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Title or Position | OWNER
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Name | DR. OLAF HAROLDSON JR.
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Credential | M.D.
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Telephone | 609-655-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 25MA01798500
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License Number State | NJ
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