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General NPI Number Information
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NPI Number | 1851420707
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Entity Type | Organization
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Legal Business Name | ATLANTIC HEMATOLOGY ONCOLOGY GROUP
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 4 E JIMMIE LEEDS RD SUITE 4
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City | GALLOWAY
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State | NJ
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Zip | 08205-4465
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Country | US
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Telephone | 609-652-6750
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Fax | 609-652-2306
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Provider Business Mailing Address
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Address Line | 4 E JIMMIE LEEDS RD SUITE 4
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City | GALLOWAY
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State | NJ
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Zip | 08205-4465
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Country | US
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Telephone | 609-652-6750
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Fax | 609-652-2306
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MAL HOLLANDER
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Credential |
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Telephone | 609-652-6750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 25MA05242500
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License Number State | NJ
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