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General NPI Number Information
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NPI Number | 1730749946
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Entity Type | Individual
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Provider Name | JASON JOSEPH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 447 WILLIAM ST
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City | EAST ORANGE
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State | NJ
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Zip | 07017-2204
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Country | US
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Telephone | 862-520-1063
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Fax |
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Provider Business Mailing Address
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Address Line | 134 CENTRE AVE FL 1
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City | SECAUCUS
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State | NJ
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Zip | 07094-3236
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Country | US
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Telephone | 551-574-0683
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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 | 28RI03171000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 28RC00012400
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License Number State | NJ
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