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General NPI Number Information
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NPI Number | 1528846847
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Entity Type | Organization
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Legal Business Name | BRANCH CARE CORP
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 220 5TH AVE FL 17
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City | NEW YORK
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State | NY
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Zip | 10001-8026
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Country | US
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Telephone | 951-805-9110
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Fax |
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Provider Business Mailing Address
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Address Line | 220 5TH AVE FL 17
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City | NEW YORK
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State | NY
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Zip | 10001-8026
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Country | US
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Telephone | 951-805-9110
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE MEDICAL DIRECTOR
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Name | DR. JASON GOMEZ
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Credential | MD
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Telephone | 951-805-9110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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