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General NPI Number Information
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NPI Number | 1588048946
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Entity Type | Individual
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Provider Name | CONSTANTINOS DIMITRIS SALEMIS O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 45 WELLS ST SUITE 2020
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City | WESTERLY
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State | RI
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Zip | 02891
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Country | US
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Telephone | 401-596-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 905
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City | WESTWOOD
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State | MA
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Zip | 02090
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Country | US
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Telephone | 781-801-2021
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003008
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CODTG00622
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License Number State | RI
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