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General NPI Number Information
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NPI Number | 1740467893
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Entity Type | Organization
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Legal Business Name | JOANNE C. PERANIO, M.D., P.A.
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 393 CRESCENT AVE
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City | WYCKOFF
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State | NJ
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Zip | 07481-2820
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Country | US
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Telephone | 201-891-6050
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Fax | 201-891-4940
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | WYCKOFF
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State | NJ
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Zip | 07481-0129
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Country | US
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Telephone | 201-891-6050
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Fax | 201-891-4940
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MR. ALAN C. SMITH
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Credential |
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Telephone | 201-848-8250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA55545
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License Number State | NJ
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