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General NPI Number Information
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NPI Number | 1710359567
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Entity Type | Organization
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Legal Business Name | NANYAWON INC.
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 9 TAPPAN PLZ
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City | TAPPAN
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State | NY
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Zip | 10983-2814
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Country | US
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Telephone | 845-359-0589
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Fax | 845-359-0953
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Provider Business Mailing Address
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Address Line | 9 TAPPAN PLZ
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City | TAPPAN
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State | NY
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Zip | 10983-2814
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Country | US
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Telephone | 845-359-0589
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Fax | 845-359-0953
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOO H YANG
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Credential | LAC
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Telephone | 845-359-0589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 4504
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License Number State | NY
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