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General NPI Number Information
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NPI Number | 1619095015
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Entity Type | Organization
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Legal Business Name | EAST-WEST INTEGRATIVE MEDICINE PLLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 30 FIFTH AVENUE STE 1E
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 212-674-8777
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Fax | 347-287-6907
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Provider Business Mailing Address
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Address Line | 30 FIFTH AVENUE STE 1E
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 212-674-8777
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Fax | 347-287-6907
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Authorized Official
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Title or Position | PHYSICIAN AND OWNER
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Name | DR. EAMONN ADELRICH VITT
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Credential | M.D.
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Telephone | 212-674-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 233642
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License Number State | NY
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