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General NPI Number Information
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NPI Number | 1518162882
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Entity Type | Individual
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Provider Name | FAGUNA C. PATEL D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 10/02/2018
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Provider Practice Location Address
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Address Line | 105 MAXESS RD STE 124
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City | MELVILLE
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State | NY
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Zip | 11747-3821
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Country | US
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Telephone | 631-229-9522
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Fax | 800-895-8150
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Provider Business Mailing Address
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Address Line | 105 MAXESS RD STE 124
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City | MELVILLE
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State | NY
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Zip | 11747-3821
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Country | US
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Telephone | 631-229-9522
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Fax | 800-895-8150
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 253578
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License Number State | NY
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