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General NPI Number Information
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NPI Number | 1740879055
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Entity Type | Organization
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Legal Business Name | NY ENDOVASCULAR CENTER LLC
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 505 E 116TH ST STE 300
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City | NEW YORK
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State | NY
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Zip | 10029-1704
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Country | US
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Telephone | 646-791-2274
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Fax | 646-791-2435
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Provider Business Mailing Address
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Address Line | 182 INDUSTRIAL RD
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City | GLEN ROCK
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State | PA
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Zip | 17327-8626
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Country | US
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Telephone | 833-426-3636
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Fax | 717-759-5435
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ISRAEL SCHUR
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Credential | MD
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Telephone | 717-759-5148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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