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General NPI Number Information
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NPI Number | 1659745289
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Entity Type | Individual
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Provider Name | ARIELLE CHRISTINA MAUCERI PA-C, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1915 RANDOLPH RD FL 3
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City | CHARLOTTE
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State | NC
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Zip | 28207-1101
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Country | US
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Telephone | 43-232-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 PARK RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28209-2290
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Country | US
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Telephone | 704-323-2090
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-15051
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License Number State | NC
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