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General NPI Number Information
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NPI Number | 1538183462
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Entity Type | Individual
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Provider Name | SANFORD BRUCE RATNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 20615 HILLSIDE AVE
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City | QUEENS VILLAGE
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State | NY
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Zip | 11427-1709
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Country | US
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Telephone | 718-776-0101
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Fax | 718-776-4841
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Provider Business Mailing Address
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Address Line | 2800 MARCUS AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1113
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Country | US
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Telephone | 516-622-6000
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 140102
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License Number State | NY
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