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General NPI Number Information
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NPI Number | 1538884929
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Entity Type | Individual
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Provider Name | ASHUTOSH HARISH AILANI DPM
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Gender | Male
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 504 W BASELINE RD STE E
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City | GLENDORA
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State | CA
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Zip | 91740-4837
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Country | US
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Telephone | 626-963-0302
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Fax | 626-963-4703
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Provider Business Mailing Address
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Address Line | 1009 BAY AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3701
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Country | US
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Telephone | 732-288-0792
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5889
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License Number State | CA
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