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General NPI Number Information
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NPI Number | 1730181082
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTH CENTER, LLC
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 220 E 161ST ST
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City | BRONX
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State | NY
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Zip | 10451-3528
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Country | US
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Telephone | 718-537-5000
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Fax | 718-537-7021
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Provider Business Mailing Address
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Address Line | PO BOX 7610
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City | GARDEN CITY
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State | NY
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Zip | 11530-0726
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Country | US
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Telephone | 516-683-3900
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Fax | 516-683-2184
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CRAIG B SANDERS
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Credential |
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Telephone | 516-683-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NY
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