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General NPI Number Information
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NPI Number | 1770773293
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Entity Type | Individual
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Provider Name | PAUL NESTOR
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Gender | Male
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 112 UNION BRIDGE RD
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City | DUXBURY
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State | MA
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Zip | 02332-4229
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Country | US
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Telephone | 617-287-6387
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Fax |
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Provider Business Mailing Address
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Address Line | 112 UNION BRIDGE RD
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City | DUXBURY
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State | MA
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Zip | 02332-4229
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 4520
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License Number State | MA
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