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General NPI Number Information
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NPI Number | 1760836407
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Entity Type | Individual
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Provider Name | GOPAL KATKORIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 300 SEASIDE AVE
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City | MILFORD
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State | CT
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Zip | 06460-4603
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Country | US
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Telephone | 203-688-1734
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | BUFFALO
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State | NY
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Zip | 14213-0007
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | T5938
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 299507
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 79413
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License Number State | CT
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