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NPI 1649603903

NPI 1649603903 : DANIEL ORTIZ L.AC. : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1649603903
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL ORTIZ L.AC.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/09/2013
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    Last Update Date     |    08/09/2013
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Provider Practice Location Address
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    Address Line         |    594 GRAND ST 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11211-4802
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    Country              |    US
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    Telephone            |    917-688-6748
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11937 METROPOLITAN AVE APT. 3C
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    City                 |    KEW GARDENS
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    State                |    NY
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    Zip                  |    11415-2605
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    Country              |    US
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    Telephone            |    917-688-6748
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    005063
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    License Number State |    NY
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