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General NPI Number Information
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NPI Number | 1669463279
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Entity Type | Individual
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Provider Name | ANGELA DEROBERTIS MD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1703 INNOVATION DR STE 100
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City | YORK
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State | PA
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Zip | 17408-8815
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Country | US
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Telephone | 717-801-0742
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 INNOVATION DR STE 100
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City | YORK
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State | PA
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Zip | 17408-8815
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Country | US
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Telephone | 717-801-0742
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 13785
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 223387
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD066735L
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License Number State | PA
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