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General NPI Number Information
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NPI Number | 1710167259
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Entity Type | Organization
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Legal Business Name | WEST SIDE RETINAL & OPHTHALMIC SURGERY PC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 3725 HENRY HUDSON PKWY
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City | BRONX
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State | NY
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Zip | 10463-1527
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Country | US
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Telephone | 917-779-8406
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 237114
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City | NEW YORK
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State | NY
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Zip | 10023-0030
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Country | US
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Telephone | 212-799-6677
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. HARRY M. ENGEL
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Credential | M.D.
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Telephone | 212-799-6677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 142272
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License Number State | NY
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