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General NPI Number Information
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NPI Number | 1588060149
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Entity Type | Organization
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Legal Business Name | WESTERN NEW YORK MEDICAL PRACTICE PC
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 7 AMBULANCE DR
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1134
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Country | US
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Telephone | 315-462-5711
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Fax | 315-462-5361
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Provider Business Mailing Address
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Address Line | 7 AMBULANCE DR
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-1134
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Country | US
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Telephone | 315-462-5711
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Fax | 315-462-5361
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Authorized Official
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Title or Position | SVP-FINANCE
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Name | PAULA TINCH
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Credential |
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Telephone | 585-922-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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