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NPI 1679147433

NPI 1679147433 : NICOLE ANNE MAY : STAMFORD, CT

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General NPI Number Information
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    NPI Number           |    1679147433
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE ANNE MAY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2021
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    Last Update Date     |    05/17/2021
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Provider Practice Location Address
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    Address Line         |    1200 HIGH RIDGE ROAD 3RD FLOOR
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    City                 |    STAMFORD
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    State                |    CT
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    Zip                  |    06905
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    Country              |    US
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    Telephone            |    917-365-9414
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1200 HIGH RIDGE RD 
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    City                 |    STAMFORD
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    State                |    CT
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    Zip                  |    06905-1223
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    Country              |    US
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    Telephone            |    917-365-9414
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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       |    5472
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    License Number State |    CT
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