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General NPI Number Information
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NPI Number | 1619240165
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Entity Type | Organization
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Legal Business Name | JILL P KAVALER MD PC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 68 E 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10028-1012
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Country | US
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Telephone | 201-767-2123
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Fax | 718-994-9682
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Provider Business Mailing Address
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Address Line | 11 BOGERT RD
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City | DEMAREST
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State | NJ
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Zip | 07627-1201
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Country | US
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Telephone | 201-767-2123
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Fax | 201-750-8610
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JILL P KAVALER
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Credential | M.D.
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Telephone | 201-767-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 193398
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License Number State | NY
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