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General NPI Number Information
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NPI Number | 1891942702
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Entity Type | Individual
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Provider Name | MARIE-LAURE DESORMEAUX M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 2201 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1859
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Country | US
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Telephone | 516-572-3203
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Fax | 516-572-8894
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Provider Business Mailing Address
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Address Line | 22341 114TH RD
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1222
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Country | US
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Telephone | 718-479-8839
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Fax | 718-479-8839
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | NOT YET
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License Number State | NY
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