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General NPI Number Information
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NPI Number | 1871757559
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Entity Type | Organization
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Legal Business Name | TRISTATE VEIN CENTERS LLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 3006 GLENMORE AVE SUITE B
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City | CINCINNATI
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State | OH
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Zip | 45238-2203
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Country | US
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Telephone | 513-662-8346
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Fax | 513-662-0033
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Provider Business Mailing Address
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Address Line | 3006 GLENMORE AVE SUITE B
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City | CINCINNATI
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State | OH
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Zip | 45238-2203
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Country | US
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Telephone | 513-662-8346
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Fax | 513-662-0033
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. FARZIN FORUHARI
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Credential | M.D.
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Telephone | 513-662-8346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 35083656
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 35077989
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License Number State | OH
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