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NPI 1578802567

NPI 1578802567 : STEPHANIE MARYANN URBINO LMSW : KENMORE, NY

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General NPI Number Information
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    NPI Number           |    1578802567
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHANIE MARYANN URBINO LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/11/2013
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    Last Update Date     |    02/11/2013
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Provider Practice Location Address
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    Address Line         |    37 E HAZELTINE AVE 
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    City                 |    KENMORE
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    State                |    NY
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    Zip                  |    14217-2705
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    Country              |    US
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    Telephone            |    716-361-5524
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    37 E HAZELTINE AVE 
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    City                 |    KENMORE
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    State                |    NY
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    Zip                  |    14217-2705
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    Country              |    US
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    Telephone            |    716-361-5524
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    075837-1
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    License Number State |    NY
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