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General NPI Number Information
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NPI Number | 1699900340
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Entity Type | Individual
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Provider Name | LEONIDEZ DE GUZMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 50 GUION PL APT 4K
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5516
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Country | US
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Telephone | 914-318-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 600 NW 11TH ST STE E37
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City | HERMISTON
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State | OR
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Zip | 97838-8604
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Country | US
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Telephone | 914-318-7428
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD154002
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License Number State | OR
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