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General NPI Number Information
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NPI Number | 1548550973
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Entity Type | Individual
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Provider Name | MR. JAMIE FUSCO
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Gender | Male
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 1459 ATWOOD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-7706
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Country | US
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Telephone | 401-273-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 25 OAK VALLEY LN
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City | HARRISVILLE
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State | RI
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Zip | 02830-1892
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Country | US
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Telephone | 401-710-7872
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH04477
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License Number State | RI
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