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General NPI Number Information
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NPI Number | 1740959675
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Entity Type | Organization
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Legal Business Name | CARE PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 220 MINEOLA BLVD STE 8
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City | MINEOLA
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State | NY
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Zip | 11501-2533
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Country | US
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Telephone | 516-742-0320
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Fax |
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Provider Business Mailing Address
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Address Line | 3 WHEELER AVE
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City | ALBERTSON
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State | NY
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Zip | 11507-1609
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Country | US
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Telephone | 917-470-5011
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MADHU G RAJANNA
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Credential | MD
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Telephone | 917-470-5011
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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 |
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License Number State |
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