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General NPI Number Information
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NPI Number | 1720269442
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Entity Type | Individual
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Provider Name | THOMAS LAIOSA
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Gender | Male
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 535 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-5117
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Country | US
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Telephone | 585-266-5930
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Fax | 585-266-5374
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Provider Business Mailing Address
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Address Line | 287 E LINDEN AVE
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City | EAST ROCHESTER
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State | NY
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Zip | 14445-1205
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 034156
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License Number State | NY
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