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General NPI Number Information
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NPI Number | 1821353970
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Entity Type | Individual
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Provider Name | DASHI BAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 13620 MAPLE AVE # C901
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City | FLUSHING
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State | NY
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Zip | 11355-5166
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Country | US
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Telephone | 917-285-2780
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Fax | 917-285-2776
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Provider Business Mailing Address
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Address Line | 13620 MAPLE AVE # C901
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City | FLUSHING
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State | NY
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Zip | 11355-5166
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Country | US
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Telephone | 917-285-2780
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Fax | 718-709-7589
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 265628
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License Number State | NY
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