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General NPI Number Information
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NPI Number | 1497789473
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Entity Type | Organization
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Legal Business Name | SOMERSET OPHTHALMOLOGY PC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 2877 CROOKS RD SUITE B
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City | TROY
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State | MI
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Zip | 48084-4717
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Country | US
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Telephone | 248-822-7003
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Fax | 248-822-7008
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Provider Business Mailing Address
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Address Line | 2877 CROOKS RD SUITE B
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City | TROY
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State | MI
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Zip | 48084
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Country | US
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Telephone | 248-822-7003
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Fax | 248-822-7003
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Authorized Official
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Title or Position | OWNER
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Name | DR. A LUISA DILORENZO
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Credential | MD
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Telephone | 248-822-7006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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