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General NPI Number Information
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NPI Number | 1548599418
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Entity Type | Organization
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Legal Business Name | VITREORETINAL & UVEITIS SERVICES, PC
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Dates
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Enumeration Date | 12/23/2009
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 8212 151ST AVE
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City | HOWARD BEACH
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State | NY
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Zip | 11414-1761
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Country | US
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Telephone | 718-845-4400
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Fax | 718-738-8198
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Provider Business Mailing Address
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Address Line | PO BOX 1203
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City | BELLMORE
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State | NY
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Zip | 11710-0486
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Country | US
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Telephone | 516-783-6692
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Fax | 516-826-6196
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH CRAPOTTA
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Credential | MD
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Telephone | 516-551-5427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 166756
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License Number State | NY
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