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General NPI Number Information
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NPI Number | 1619403177
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL CARE SERVICE, PLLC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 260 SAINT NICHOLAS AVE GROUND FL
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City | BROOKLYN
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State | NY
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Zip | 11237-5430
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Country | US
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Telephone | 347-240-8632
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1422
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City | NEW YORK
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State | NY
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Zip | 10028-0012
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Country | US
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Telephone | 347-240-8632
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Fax |
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Authorized Official
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Title or Position | STAFF
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Name | BIBI ISHMAEL
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Credential |
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Telephone | 347-240-8632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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