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General NPI Number Information
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NPI Number | 1699785873
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Entity Type | Individual
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Provider Name | ADAM SHOUKRY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 12/30/2012
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Provider Practice Location Address
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Address Line | 85 N PARK AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4105
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Country | US
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Telephone | 516-763-4500
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Fax | 516-763-4502
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Provider Business Mailing Address
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Address Line | 72-38 113TH STREET APT. 3C
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 347-622-8508
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 052188
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License Number State | NY
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