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NPI 1528572690

NPI 1528572690 : STACEY ZGALJARDIC : ROSLYN HEIGHTS, NY

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General NPI Number Information
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    NPI Number           |    1528572690
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    Entity Type          |    Individual 
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    Provider Name        |    STACEY ZGALJARDIC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/27/2017
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    Last Update Date     |    11/27/2017
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Provider Practice Location Address
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    Address Line         |    1 EXPRESSWAY PLZ STE 106 
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    City                 |    ROSLYN HEIGHTS
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    State                |    NY
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    Zip                  |    11577-2069
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    Country              |    US
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    Telephone            |    516-621-2524
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5407 BROWVALE LN 
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    City                 |    LITTLE NECK
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    State                |    NY
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    Zip                  |    11362-1701
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    Country              |    US
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    Telephone            |    646-267-8111
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    Fax                  |    
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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        |    103TS0200X
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    Taxonomy Name        |    School Psychologist
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    License Number       |    
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    License Number State |    NY
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