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General NPI Number Information
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NPI Number | 1881053676
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Entity Type | Organization
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Legal Business Name | SOOD MEDICAL PRACTICE, LLC
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 50 MOUNT PROSPECT AVE STE 209
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City | CLIFTON
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State | NJ
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Zip | 07013-1900
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Country | US
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Telephone | 862-238-8250
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Fax | 862-238-8255
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Provider Business Mailing Address
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Address Line | PO BOX 4222
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City | CLIFTON
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State | NJ
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Zip | 07012-8222
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Country | US
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Telephone | 862-238-8250
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Fax | 862-238-8255
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SOOD RAHUL
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Credential | M.D
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Telephone | 732-261-0207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 25MB08610000
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License Number State | NJ
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