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General NPI Number Information
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NPI Number | 1679826036
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Entity Type | Individual
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Provider Name | ADAM ROBERT TERNOSKY PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 1101 SOUTH CEDAR CREST BLVD.
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City | ALLENTOWN
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State | PA
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Zip | 18103-7902
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Country | US
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Telephone | 610-435-3111
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Fax | 610-432-5953
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Provider Business Mailing Address
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Address Line | 1253 RAYMOND AVENUE
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City | BETHLEHEM
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State | PA
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Zip | 18018
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Country | US
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Telephone | 610-428-7093
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA002938
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License Number State | PA
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