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General NPI Number Information
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NPI Number | 1487466264
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Entity Type | Organization
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Legal Business Name | MIRACLE HILL LLC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 70 E SUNRISE HWY
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City | VALLEY STREAM
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State | NY
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Zip | 11581-1240
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Country | US
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Telephone | 516-688-5217
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Fax | 888-615-3745
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Provider Business Mailing Address
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Address Line | 22901 LINDEN BLVD
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City | JAMAICA
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State | NY
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Zip | 11411-1897
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Country | US
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Telephone | 516-688-5217
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Fax | 888-615-3745
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY HERNANDEZ
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Credential |
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Telephone | 917-653-0916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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