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General NPI Number Information
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NPI Number | 1669167490
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Entity Type | Organization
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Legal Business Name | M. L. BOSE MEMORIAL HEALTH FOUNDATION, INC.
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Dates
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Enumeration Date | 04/07/2023
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 327 DICKERSON DR N
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City | CAMILLUS
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State | NY
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Zip | 13031-1703
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Country | US
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Telephone | 520-878-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 327 DICKERSON DR N
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City | CAMILLUS
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State | NY
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Zip | 13031-1703
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Country | US
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Telephone | 520-878-3600
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MR. ASHOKE BOSE
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Credential | MHA
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Telephone | 520-878-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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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 | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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