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General NPI Number Information
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NPI Number | 1467271049
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Entity Type | Organization
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Legal Business Name | ROOT HEALTH PRIMARY CARE
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 115 ROUTE 46 W BLDG F
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City | MOUNTAIN LAKES
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State | NJ
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Zip | 07046-1668
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Country | US
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Telephone | 862-832-2353
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Fax |
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Provider Business Mailing Address
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Address Line | 17 SANDERS RD
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City | ROCKAWAY
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State | NJ
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Zip | 07866-2008
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Country | US
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Telephone | 973-222-7636
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Fax |
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Authorized Official
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Title or Position | FOUNDER, APN
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Name | KRISTEN DENARO
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Credential |
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Telephone | 862-832-2353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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