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General NPI Number Information
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NPI Number | 1629246087
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Entity Type | Organization
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Legal Business Name | UNITED CEREBRAL PALSY
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 175 LAWRENCE AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-1102
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Country | US
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Telephone | 718-436-7600
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Fax | 718-907-3172
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Provider Business Mailing Address
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Address Line | 175 LAWRENCE AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-1102
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Country | US
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Telephone | 718-436-7600
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Fax | 718-907-3172
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MICHELLE IRENE STRAKOSCH
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Credential | BSN
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Telephone | 631-255-3677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 588747-1
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License Number State | NY
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