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General NPI Number Information
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NPI Number | 1649476854
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Entity Type | Organization
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Legal Business Name | SETH STOLLER LLC
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 11 OVERLOOK RD SUITE B110
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City | SUMMIT
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State | NJ
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Zip | 07901-3577
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Country | US
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Telephone | 908-522-2709
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Fax | 908-273-1553
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Provider Business Mailing Address
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Address Line | 158 W 27TH ST 11TH FLOOR SOUTH
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City | NEW YORK
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State | NY
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Zip | 10001-6216
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Country | US
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Telephone | 212-563-2497
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Fax | 212-563-0605
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SETH STOLLER
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Credential | M.D.
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Telephone | 212-563-2497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA07912600
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License Number State | NJ
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