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General NPI Number Information
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NPI Number | 1649616798
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Entity Type | Organization
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Legal Business Name | GENESIS PENNYPACK CENTER
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 8015 LAWNDALE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-1507
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Country | US
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Telephone | 215-725-2525
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Fax | 215-745-3970
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Provider Business Mailing Address
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Address Line | 8015 LAWNDALE STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19111-1507
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Country | US
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Telephone | 215-725-2525
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Fax | 215-745-3970
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. EDWIN MEROW
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Credential | DO
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Telephone | 215-725-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OS001737L
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License Number State | PA
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