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General NPI Number Information
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NPI Number | 1831513530
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Entity Type | Organization
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Legal Business Name | BLOSSOM DAY CARE CENTER LLC
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Dates
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Enumeration Date | 02/15/2014
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Last Update Date | 02/15/2014
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Provider Practice Location Address
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Address Line | 4260 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-4709
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Country | US
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Telephone | 718-813-1868
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Fax |
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Provider Business Mailing Address
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Address Line | 6924 168TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3214
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. KWOK LEE
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Credential | PRESIDENT
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Telephone | 917-709-7933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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