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General NPI Number Information
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NPI Number | 1609052562
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Entity Type | Individual
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Provider Name | PAULA J LEWYCKYJ
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 114 N MAIN ST
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City | FAIRPORT
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State | NY
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Zip | 14450-1432
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Country | US
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Telephone | 585-678-4258
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Fax |
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Provider Business Mailing Address
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Address Line | 7194 HERTFORDSHIRE WAY
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City | VICTOR
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State | NY
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Zip | 14564-1171
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Country | US
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Telephone | 585-305-2269
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 046329
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License Number State | NY
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