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General NPI Number Information
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NPI Number | 1588718555
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Entity Type | Organization
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Legal Business Name | WESTSIDE PODIATRY CENTER, LLP
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5415 W GENESEE ST SUITE 203
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City | CAMILLUS
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State | NY
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Zip | 13031-2162
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Country | US
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Telephone | 315-701-3348
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Fax | 315-701-0949
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Provider Business Mailing Address
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Address Line | 8280 WILLETT PKWY SUITE 101
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-1325
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Country | US
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Telephone | 315-857-0140
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Fax | 315-857-0144
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | JAMES WILLIAM FARRELL
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Credential | D.P.M.
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Telephone | 315-857-0140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N003729
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License Number State | NY
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