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General NPI Number Information
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NPI Number | 1861714388
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Entity Type | Organization
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Legal Business Name | COASTAL MEDICAL SLEEP DISORDERS CENTER
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 450 VETERANS MEMORIAL PKWY BLDG 9B
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-5300
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Country | US
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Telephone | 401-438-9607
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Fax | 401-431-2555
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Provider Business Mailing Address
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Address Line | 10 DAVOL SQ SUITE 400
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City | PROVIDENCE
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State | RI
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Zip | 02903-4754
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Country | US
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Telephone | 401-421-4000
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Fax | 401-272-1456
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Authorized Official
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Title or Position | COO
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Name | MERYL MOSS
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Credential |
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Telephone | 401-421-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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