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General NPI Number Information
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NPI Number | 1548787732
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Entity Type | Organization
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Legal Business Name | MANISH PATEL ORTHODONTIST, PC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 33 NY-17M SUITE E
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City | HARRIMAN
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State | NY
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Zip | 10926
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Country | US
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Telephone | 845-774-2724
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Fax |
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Provider Business Mailing Address
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Address Line | 11 HIDDEN GLEN RD
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City | SCARSDALE
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State | NY
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Zip | 10583-1230
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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 | PRESIDENT
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Name | DR. MANISH PATEL
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Credential | DDS
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Telephone | 914-589-3726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 058538-1
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License Number State | NY
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