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General NPI Number Information
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NPI Number | 1740753441
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Entity Type | Organization
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Legal Business Name | VALLEY STREAM RX INC
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 209 ROCKAWAY AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5825
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Country | US
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Telephone | 516-284-7257
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Fax | 516-612-2639
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Provider Business Mailing Address
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Address Line | 209 ROCKAWAY AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5825
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Country | US
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Telephone | 516-284-7257
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Fax | 516-612-2639
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NIKITA BLUMENTAL
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Credential |
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Telephone | 323-573-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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