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General NPI Number Information
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NPI Number | 1669421236
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Entity Type | Individual
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Provider Name | STEPHANIE ALEXIS DAVIDOFF M.D. PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 27 MICA LN SUITE 205
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City | WELLESLEY
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State | MA
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Zip | 02481-1724
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Country | US
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Telephone | 781-751-1275
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Fax | 781-235-7912
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Provider Business Mailing Address
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Address Line | 76 WHITNEY ST
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City | SHERBORN
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State | MA
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Zip | 01770-1006
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Country | US
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Telephone | 508-653-8398
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Fax | 508-655-6510
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 76772
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License Number State | MA
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