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General NPI Number Information
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NPI Number | 1720921109
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Entity Type | Individual
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Provider Name | MR. JAYCE-TYLER HARMON
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Gender | Male
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 300 POMPTON RD
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City | WAYNE
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State | NJ
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Zip | 07470-2103
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Country | US
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Telephone | 973-720-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BIG POND DR
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City | MILFORD
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State | DE
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Zip | 19963-3912
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Country | US
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Telephone | 302-569-1403
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | NJ
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