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NPI 1841200862

NPI 1841200862 : MARC VON ROEMER MD : LAKEWOOD, NJ

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General NPI Number Information
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    NPI Number           |    1841200862
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    Entity Type          |    Individual 
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    Provider Name        |    MARC VON ROEMER MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/09/2006
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    1 HIGHWAY 70 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5895
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    Country              |    US
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    Telephone            |    732-905-5600
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    Fax                  |    732-905-8604
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Provider Business Mailing Address
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    Address Line         |    1 HIGHWAY 70 
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    City                 |    LAKEWOOD
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    State                |    NJ
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    Zip                  |    08701-5895
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    Country              |    US
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    Telephone            |    732-905-5600
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    Fax                  |    732-905-8604
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    MA071381
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    License Number State |    NJ
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