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General NPI Number Information
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NPI Number | 1467868430
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Entity Type | Individual
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Provider Name | ANNE SPICHLER MOFFARAH MD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 800 HOWARD AVE
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City | NEW HAVEN
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State | CT
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Zip | 06519-1369
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Country | US
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Telephone | 203-785-3561
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208022
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City | NEW HAVEN
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State | CT
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Zip | 06520-8022
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Country | US
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Telephone | 203-785-4140
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Fax |
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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 | 147789
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 63780
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License Number State | CT
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