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General NPI Number Information
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NPI Number | 1669786406
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Entity Type | Individual
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Provider Name | MRS. PAULA MOE
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 09/13/2017
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Provider Practice Location Address
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Address Line | 309 E 45TH ST
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City | NEW YORK
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State | NY
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Zip | 10017-3433
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Country | US
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Telephone | 612-817-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 320 E 23RD ST 16G
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City | NEW YORK
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State | NY
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Zip | 10010-4713
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Country | US
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Telephone |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 016260-1
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License Number State | NY
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