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General NPI Number Information
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NPI Number | 1548402613
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Entity Type | Organization
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Legal Business Name | ORVILLE PALMER, M.D.
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 1783 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-4537
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Country | US
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Telephone | 212-348-6001
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Fax | 212-348-6067
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Provider Business Mailing Address
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Address Line | PO BOX 891
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City | NEW YORK
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State | NY
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Zip | 10037-0891
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Country | US
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Telephone | 347-539-9023
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Fax | 718-471-4791
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Authorized Official
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Title or Position | OWNER
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Name | DR. ORVILLE DAVE PALMER
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Credential | M.D.
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Telephone | 917-501-6193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 208819
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License Number State | NY
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