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General NPI Number Information
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NPI Number | 1619205929
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Entity Type | Individual
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Provider Name | MICHAEL EDWIN KAFRISSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 11/24/2009
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Provider Practice Location Address
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Address Line | 1000 ROUTE 202
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City | RARITAN
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State | NJ
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Zip | 08869-1425
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Country | US
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Telephone | 908-704-4609
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Fax | 908-218-0460
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Provider Business Mailing Address
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Address Line | PO BOX 165
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City | GLADSTONE
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State | NJ
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Zip | 07934-0165
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Country | US
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Telephone | 908-704-4609
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Fax | 908-218-0460
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD017180E
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License Number State | PA
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