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NPI 1639609134

NPI 1639609134 : REGINA GUREVICH DDS : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1639609134
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    Entity Type          |    Individual 
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    Provider Name        |    REGINA GUREVICH DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/16/2017
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    Last Update Date     |    06/16/2017
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Provider Practice Location Address
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    Address Line         |    345 E 24TH ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-4020
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    Country              |    US
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    Telephone            |    347-306-2811
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    Fax                  |    347-306-2811
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Provider Business Mailing Address
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    Address Line         |    127 PEMBROKE ST 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11235-2312
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    Country              |    US
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    Telephone            |    347-306-2811
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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