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NPI 1720468176

NPI 1720468176 : MICHELLE Q MIU : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1720468176
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    Entity Type          |    Individual 
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    Provider Name        |    MICHELLE Q MIU
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/01/2015
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    Last Update Date     |    06/01/2015
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Provider Practice Location Address
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    Address Line         |    219 CANAL ST FL 3 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10013-4114
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    Country              |    US
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    Telephone            |    646-476-3021
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    219 CANAL ST FL 3 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10013-4114
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    Country              |    US
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    Telephone            |    646-476-3021
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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        |    156FX1100X
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    Taxonomy Name        |    Ophthalmic Technician/Technologist
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    License Number       |    008841
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    License Number State |    NY
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