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General NPI Number Information
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NPI Number | 1497796825
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Entity Type | Individual
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Provider Name | MARIO PASSARO LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 481 MAIN ST SUITE 403-A
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-6324
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Country | US
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Telephone | 914-912-4859
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Fax | 914-235-0822
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Provider Business Mailing Address
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Address Line | 630 GRAMATAN AVE APT 2 -F
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City | MOUNT VERNON
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State | NY
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Zip | 10552-1840
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Country | US
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Telephone | 914-665-1218
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Fax | 914-235-0822
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5343343
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License Number State | NY
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