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General NPI Number Information
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NPI Number | 1477931319
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Entity Type | Individual
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Provider Name | VANESSA JEAN STAGLIANO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 10553 SAINT CLAIR AVE
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City | CLEVELAND
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State | OH
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Zip | 44108-1973
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Country | US
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Telephone | 216-682-7702
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Fax | 216-920-6273
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Provider Business Mailing Address
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Address Line | PO BOX 746071
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City | ATLANTA
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State | GA
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Zip | 30374-6071
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Country | US
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Telephone | 312-733-9730
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TE061308
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.133964
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License Number State | OH
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