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General NPI Number Information
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NPI Number | 1528342458
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Entity Type | Organization
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Legal Business Name | RESTORX
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 420 VALLEY VIEW RD
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1621
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Country | US
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Telephone | 917-734-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 420 VALLEY VIEW RD
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-1621
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Country | US
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Telephone | 917-734-1558
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. AVRAHAM J SCHREIBER
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Credential | M.D.
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Telephone | 917-734-1558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MAO65093
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License Number State | NJ
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