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General NPI Number Information
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NPI Number | 1891802559
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Entity Type | Individual
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Provider Name | CONGZHEN OU MD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 E BROADWAY STE 105
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City | NEW YORK
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State | NY
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Zip | 10038-1073
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Country | US
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Telephone | 212-248-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 KISSENA BLVD STE 1J
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City | FLUSHING
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State | NY
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Zip | 11355-3769
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Country | US
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Telephone | 212-248-0850
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 208613
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License Number State | NY
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