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General NPI Number Information
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NPI Number | 1689101842
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Entity Type | Individual
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Provider Name | CAITLIN ELIZABETH MCQUEEN OD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 1070 IYANNOUGH RD
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City | HYANNIS
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State | MA
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Zip | 02601-1871
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Country | US
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Telephone | 508-771-9701
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Fax | 508-778-6663
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Provider Business Mailing Address
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Address Line | 13 HIGHFIELD DR
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City | SANDWICH
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State | MA
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Zip | 02563-2916
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Country | US
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Telephone | 508-737-2572
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OEG003330
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OEG003330
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003330
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License Number State | PA
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