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General NPI Number Information
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NPI Number | 1477069128
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Entity Type | Individual
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Provider Name | JAMIE LAUREN MAXWELL
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Gender | Female
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 442 E HOUSTON ST
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City | NEW YORK
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State | NY
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Zip | 10002-1122
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Country | US
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Telephone | 212-677-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 501 OXFORD RD
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City | CEDARHURST
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State | NY
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Zip | 11516-1138
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Country | US
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Telephone | 516-554-4064
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0220111
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License Number State | NY
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