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General NPI Number Information
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NPI Number | 1629235734
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Entity Type | Individual
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Provider Name | MORRIE M SUKOFF DPM
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Gender | Male
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Dates
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Enumeration Date | 05/18/2008
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 2 TYRAM LN
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City | COMMACK
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State | NY
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Zip | 11725-1319
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Country | US
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Telephone | 631-486-4815
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TYRAM LN
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City | COMMACK
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State | NY
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Zip | 11725-1319
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Country | US
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Telephone | 631-486-4815
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | P51869
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License Number State | NY
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