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General NPI Number Information
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NPI Number | 1598745820
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Entity Type | Individual
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Provider Name | ANGELA GAGLIARDI MD
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 BRADHURST AVE
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City | HAWTHORNE
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State | NY
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Zip | 10532-2140
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Country | US
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Telephone | 914-594-3916
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Fax | 914-594-3747
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Provider Business Mailing Address
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Address Line | 22 SAW MILL RIVER RD
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City | HAWTHORNE
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State | NY
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Zip | 10532-1533
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Country | US
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Telephone | 914-593-1729
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Fax | 914-593-1790
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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 | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | 232061
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License Number State | NY
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