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General NPI Number Information
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NPI Number | 1497823645
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Entity Type | Organization
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Legal Business Name | ELLIOTH FISHKIN MD LLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 776 E 3RD AVE
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City | ROSELLE
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State | NJ
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Zip | 07203-1698
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Country | US
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Telephone | 908-259-8817
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Fax | 908-259-8846
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Provider Business Mailing Address
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Address Line | 776 E 3RD AVE
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City | ROSELLE
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State | NJ
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Zip | 07203-1698
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Country | US
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Telephone | 908-259-8817
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Fax | 908-259-8846
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. KAREN COCCA
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Credential | RN
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Telephone | 908-259-8817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 25MA03429100
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License Number State | NJ
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