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General NPI Number Information
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NPI Number | 1821119546
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Entity Type | Organization
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Legal Business Name | THOMAS E PENN MD PLLC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 919 WESTFALL ROAD B100
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-454-6610
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Fax | 585-454-6564
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Provider Business Mailing Address
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Address Line | 919 WESTFALL RD B100
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-454-6610
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Fax | 585-454-6564
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Authorized Official
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Title or Position | OWNER, SELF
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Name | THOMAS E PENN
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Credential | MD
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Telephone | 585-454-6610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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