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General NPI Number Information
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NPI Number | 1760877625
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Entity Type | Individual
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Provider Name | ANDREA RACHEL MARCUS M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 425 POST RD FL 1
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City | FAIRFIELD
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State | CT
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Zip | 06824-6232
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Country | US
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Telephone | 475-210-4727
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Fax | 475-210-4729
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HIGHWAY HHC - CVO
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City | WETHERSFIELD
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State | CT
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Zip | 06109-4337
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 79046
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 79046
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License Number State | CT
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