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NPI 1689813685

NPI 1689813685 : DAVID L CANGELLO M.D., MSC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1689813685
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID L CANGELLO M.D., MSC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/13/2009
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    Last Update Date     |    03/29/2010
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Provider Practice Location Address
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    Address Line         |    800A 5TH AVE SUITE 302
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10065-7215
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    Country              |    US
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    Telephone            |    212-644-4416
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    Fax                  |    212-355-2788
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Provider Business Mailing Address
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    Address Line         |    800A 5TH AVE SUITE 302
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10065-7215
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    Country              |    US
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    Telephone            |    212-644-4416
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    Fax                  |    212-355-2788
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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        |    208200000X
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    Taxonomy Name        |    Plastic Surgery Physician
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    License Number       |    243450
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    License Number State |    NY
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