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General NPI Number Information
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NPI Number | 1629294806
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Entity Type | Individual
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Provider Name | NIKITA CHANDRAKANT DAVE MBBS
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 699 HERTEL AVE. INDUSTRIAL MEDICINE OFFICE
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City | BUFFALO
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State | NY
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Zip | 14216
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Country | US
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Telephone | 914-323-0312
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Fax |
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Provider Business Mailing Address
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Address Line | 195 KOENIG RD
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City | TONAWANDA
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State | NY
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Zip | 14150-7532
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Country | US
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Telephone | 716-833-9498
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 228502
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME98345
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License Number State | FL
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