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General NPI Number Information
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NPI Number | 1861933665
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Entity Type | Individual
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Provider Name | JOSEPH DEMARCO
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Gender | Male
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | ELM AND CARLTON STREETS
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City | BUFFALO
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State | NY
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Zip | 14263-0001
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Country | US
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Telephone | 716-845-2300
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Fax | 716-845-2293
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Provider Business Mailing Address
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Address Line | 179 BURMON DR
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1044
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Country | US
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Telephone | 716-845-2300
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Fax | 716-845-2293
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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