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General NPI Number Information
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NPI Number | 1588046361
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Entity Type | Organization
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Legal Business Name | NIAGARA ASC, LLC
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 6500 PORTER RD SUITE 2030
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1529
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Country | US
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Telephone | 716-285-2020
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Fax | 716-285-2060
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Provider Business Mailing Address
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Address Line | 6500 PORTER RD SUITE 2030
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1529
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Country | US
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Telephone | 716-285-2020
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Fax | 716-285-2060
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KIMBERLY FULLONE
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Credential | BS, RN,
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Telephone | 585-233-0722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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