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General NPI Number Information
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NPI Number | 1538286646
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Entity Type | Organization
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Legal Business Name | MAHOPAC RADIATION ONCOLOGY
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7 MILLER RD
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City | MAHOPAC
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State | NY
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Zip | 10541-2219
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Country | US
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Telephone | 845-628-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 7 MILLER RD
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City | MAHOPAC
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State | NY
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Zip | 10541-2219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DANIEL ARMET
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Credential |
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Telephone | 845-628-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 39018024
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License Number State | NY
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