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General NPI Number Information
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NPI Number | 1467334755
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Entity Type | Organization
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Legal Business Name | WOUND COMPANY PROVIDER GROUP NJ PC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 377 VALLEY RD. UNIT 2649
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City | CLIFTON
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State | NJ
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Zip | 07013
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Country | US
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Telephone | 859-396-3819
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 DREW AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-3646
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Country | US
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Telephone | 859-396-3819
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEX MOHSENI
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Credential | MD
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Telephone | 301-706-4461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC2100X
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Taxonomy Name | Continence Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WE0900X
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Taxonomy Name | Enterostomal Therapy Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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