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NPI 1700687324

NPI 1700687324 : PAUL SROUR : SOMERSET, NJ

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General NPI Number Information
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    NPI Number           |    1700687324
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    Entity Type          |    Individual 
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    Provider Name        |    PAUL SROUR
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/20/2025
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    Last Update Date     |    03/20/2025
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Provider Practice Location Address
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    Address Line         |    120 CEDAR GROVE LN 
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    City                 |    SOMERSET
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    State                |    NJ
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    Zip                  |    08873-6462
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    Country              |    US
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    Telephone            |    732-519-0151
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    41 CARTIER DR 
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    City                 |    FRANKLIN PARK
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    State                |    NJ
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    Zip                  |    08823-1719
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    Country              |    US
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    Telephone            |    
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    40QA02321400
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    License Number State |    NJ
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