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General NPI Number Information
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NPI Number | 1770906778
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Entity Type | Organization
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Legal Business Name | OPTICARE LLC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 620 FOSTER AVE SUITE 4B
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City | BROOKLYN
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State | NY
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Zip | 11230-1399
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Country | US
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Telephone | 718-269-4888
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Fax | 718-269-4889
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Provider Business Mailing Address
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Address Line | 620 FOSTER AVE SUITE 4B
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City | BROOKLYN
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State | NY
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Zip | 11230-1399
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Country | US
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Telephone | 718-269-4888
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Fax | 718-269-4889
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | MRS. JENI WALLACE
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Credential |
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Telephone | 718-269-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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