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General NPI Number Information
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NPI Number | 1629302013
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Entity Type | Individual
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Provider Name | MARVIN GALLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 300 HYLAN DR # 107
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City | ROCHESTER
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State | NY
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Zip | 14623-4216
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Country | US
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Telephone | 585-935-7116
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Fax | 561-886-6566
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Provider Business Mailing Address
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Address Line | 10786 ASHMONT DR
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City | BOCA RATON
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State | FL
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Zip | 33498-6403
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Country | US
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Telephone | 561-702-2257
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Fax | 561-886-6566
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 147538
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License Number State | NY
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