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General NPI Number Information
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NPI Number | 1780811141
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Entity Type | Organization
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Legal Business Name | F THEMISTOCLE MD PC
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 2445 ARTHUR AVE
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City | BRONX
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State | NY
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Zip | 10458-6003
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Country | US
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Telephone | 718-924-7909
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Fax |
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Provider Business Mailing Address
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Address Line | 9601 SPRINGFIELD BLVD
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-1327
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Country | US
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Telephone | 718-924-7909
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FENAR THEMOSTOCLE
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Credential | MD
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Telephone | 718-924-7909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 217744
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 217744
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 217774
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License Number State | NY
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