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General NPI Number Information
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NPI Number | 1801297320
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Entity Type | Individual
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Provider Name | DR. HAROLD MANDEL
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Gender | Male
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 7608 OSWEGO RD #2057
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City | LIVERPOOL
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State | NY
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Zip | 13089-5001
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Country | US
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Telephone | 315-200-9626
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2057
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City | LIVERPOOL
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State | NY
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Zip | 13089-2057
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Country | US
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Telephone | 315-378-1349
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 156164
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License Number State | NY
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