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General NPI Number Information
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NPI Number | 1588755839
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Entity Type | Individual
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Provider Name | RAMA M MOHAN M.D
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7619 101ST AVE
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City | OZONE PARK
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State | NY
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Zip | 11416-1913
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Country | US
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Telephone | 718-848-1945
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Fax |
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Provider Business Mailing Address
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Address Line | 19703 MCLAUGHLIN AVE
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City | HOLLIS
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State | NY
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Zip | 11423-1243
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Country | US
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Telephone | 718-464-2893
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Fax | 718-848-1946
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 197031
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License Number State | NY
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