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General NPI Number Information
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NPI Number | 1639487234
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Entity Type | Individual
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Provider Name | DANIEL MANOBIANCO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 7011 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5249
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Country | US
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Telephone | 480-948-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 3107 N 142ND DR
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City | GOODYEAR
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State | AZ
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Zip | 85395-8349
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Country | US
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Telephone | 623-293-2906
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Fax | 623-535-5242
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S017438
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License Number State | AZ
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