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NPI 1861598732

NPI 1861598732 : DONNALEIGH DI CHIARA ATC : TRUMBULL, CT

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General NPI Number Information
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    NPI Number           |    1861598732
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    Entity Type          |    Individual 
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    Provider Name        |    DONNALEIGH DI CHIARA ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/16/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    888 WHITE PLAINS RD 
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    City                 |    TRUMBULL
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    State                |    CT
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    Zip                  |    06611-4552
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    Country              |    US
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    Telephone            |    203-459-1133
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2759 EASTON TPKE 
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    City                 |    FAIRFIELD
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    State                |    CT
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    Zip                  |    06825-1007
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    Country              |    US
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    Telephone            |    203-373-0825
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    Fax                  |    
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    000055
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    License Number State |    CT
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