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General NPI Number Information
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NPI Number | 1710320239
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Entity Type | Organization
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Legal Business Name | HOLISTIC OB/GYN, LLC
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 1700 ROUTE 3
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City | CLIFTON
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State | NJ
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Zip | 07013-3928
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Country | US
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Telephone | 973-747-5217
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Fax | 973-396-8832
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Provider Business Mailing Address
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Address Line | PO BOX 6072
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City | CLIFTON
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State | NJ
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Zip | 07015-6072
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Country | US
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Telephone | 973-747-5217
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Fax | 973-396-8832
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Authorized Official
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Title or Position | OWNER
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Name | MS. PAOLA A ESCOBAR
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Credential | M.S.N., C.N.M
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Telephone | 973-747-5217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00038301
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License Number State | NJ
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