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General NPI Number Information
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NPI Number | 1801998018
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Entity Type | Individual
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Provider Name | ANGELO MASTROSIMONE MD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 123 FRANKLIN CORNER ROAD SUITE 105
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-896-2300
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Fax | 609-896-2211
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Provider Business Mailing Address
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Address Line | 123 FRANKLIN CORNER ROAD SUITE 105
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-896-2300
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Fax | 609-896-2211
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MA 22798
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License Number State | NJ
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