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NPI 1699855486

NPI 1699855486 : DEAN E HART OD : HICKSVILLE, NY

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General NPI Number Information
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    NPI Number           |    1699855486
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    Entity Type          |    Individual 
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    Provider Name        |    DEAN E HART OD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/16/2006
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    Last Update Date     |    05/16/2012
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Provider Practice Location Address
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    Address Line         |    185 WOODBURY RD 
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    City                 |    HICKSVILLE
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    State                |    NY
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    Zip                  |    11801-3029
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    Country              |    US
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    Telephone            |    516-681-3937
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    Fax                  |    516-681-1272
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Provider Business Mailing Address
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    Address Line         |    185 WOODBURY RD 
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    City                 |    HICKSVILLE
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    State                |    NY
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    Zip                  |    11801-3029
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    Country              |    US
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    Telephone            |    516-681-3937
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    Fax                  |    516-681-1272
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    VUT004847-1
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    License Number State |    NY
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