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General NPI Number Information
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NPI Number | 1649767013
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Entity Type | Organization
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Legal Business Name | COMPLETE EXPRESS MEDICAL PC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 3047 AVENUE U STE 2
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City | BROOKLYN
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State | NY
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Zip | 11229-5144
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Country | US
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Telephone | 347-702-4066
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Fax | 347-702-4065
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Provider Business Mailing Address
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Address Line | 3047 AVENUE U STE 2
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City | BROOKLYN
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State | NY
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Zip | 11229-5144
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Country | US
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Telephone | 347-702-4066
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Fax | 347-702-4065
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Authorized Official
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Title or Position | PRESIDENT
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Name | SVETLANA FISH
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Credential | MD
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Telephone | 917-318-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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