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General NPI Number Information
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NPI Number | 1679534176
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Entity Type | Individual
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Provider Name | PAUL ROBERT FARRELL M. D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2006
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 2640 ROUTE 70
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City | MANASQUAN
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State | NJ
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Zip | 08736-2609
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Country | US
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Telephone | 732-528-8448
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Fax | 732-223-5792
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Provider Business Mailing Address
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Address Line | 2502 EMERSON AVE
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City | SPRING LAKE HEIGHTS
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State | NJ
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Zip | 07762-2410
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Country | US
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Telephone | 732-974-8292
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Fax | 732-974-1551
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA03203500
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License Number State | NJ
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