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General NPI Number Information
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NPI Number | 1760585913
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Entity Type | Individual
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Provider Name | AGNES S. SALVADOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5501 OLD YORK RD PALEY 1ST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone | 215-456-6595
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Fax | 215-456-3436
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Provider Business Mailing Address
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Address Line | 101 E OLNEY AVE SUITE 505
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City | PHILADELPHIA
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State | PA
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Zip | 19120-2421
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Country | US
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Telephone | 215-456-7000
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Fax | 215-254-2599
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | MD037721E
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License Number State | PA
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