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General NPI Number Information
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NPI Number | 1457685653
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Entity Type | Individual
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Provider Name | GABRIELLA BEDARIDA MD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 1 HOWE ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-5473
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Country | US
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Telephone | 203-215-6988
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Fax | 203-401-0335
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Provider Business Mailing Address
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Address Line | 256 MCKINLEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06515-2012
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Country | US
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Telephone | 203-215-6988
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Fax | 203-401-0335
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045217
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License Number State | CT
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