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General NPI Number Information
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NPI Number | 1881619708
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Entity Type | Organization
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Legal Business Name | INWOOD COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 270 LAWRENCE AVE.
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City | INWOOD
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State | NY
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Zip | 11096
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Country | US
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Telephone | 516-571-7874
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Fax |
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Provider Business Mailing Address
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Address Line | 270 LAWRENCE AVE.
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City | INWOOD
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State | NY
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Zip | 11096
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Country | US
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Telephone | 516-571-7874
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | GARY BIE
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Credential |
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Telephone | 516-572-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2908201R
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License Number State | NY
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