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General NPI Number Information
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NPI Number | 1477682839
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Entity Type | Individual
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Provider Name | DEBRA L PREHODA RN,BSN
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Gender | Female
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9 GRAND AVE
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City | MECHANICVILLE
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State | NY
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Zip | 12118-2142
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Country | US
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Telephone | 518-664-7719
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Fax |
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Provider Business Mailing Address
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Address Line | 39 MEADOW RUE PL
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City | BALLSTON SPA
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State | NY
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Zip | 12020-4367
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Country | US
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Telephone | 518-899-6796
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 3556841
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License Number State | NY
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