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General NPI Number Information
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NPI Number | 1730343427
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Entity Type | Individual
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Provider Name | HEIDI FISH MD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 718 TEANECK RD HOLY NAME MEDICAL CENTER
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-3000
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Fax | 201-661-7297
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Provider Business Mailing Address
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Address Line | 535 E CRESCENT AVE C/O HISTOPATHOLOGY SERVICES, LLC
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City | RAMSEY
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State | NJ
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Zip | 07446-2922
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Country | US
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Telephone | 201-661-7280
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Fax | 201-661-7297
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 25MA07202600
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License Number State | NJ
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