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NPI 1619630423

NPI 1619630423 : PAIGE A SKINNER PA : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1619630423
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    Entity Type          |    Individual 
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    Provider Name        |    PAIGE A SKINNER PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/19/2021
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    Last Update Date     |    09/07/2022
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Provider Practice Location Address
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    Address Line         |    NYU TISCH HOSPITAL 570 FIRST AVENUE
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10016
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    Country              |    US
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    Telephone            |    678-451-6115
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    329 E 6TH ST APT 14 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10003-8485
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    Country              |    US
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    Telephone            |    678-451-6115
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    027453
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    License Number State |    NY
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