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General NPI Number Information
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NPI Number | 1902040371
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 6 EDGEWOOD DR
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-1231
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Country | US
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Telephone | 315-415-5164
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Fax |
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Provider Business Mailing Address
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Address Line | 6 EDGEWOOD DR
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-1231
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Country | US
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Telephone | 315-415-5164
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. AMANDA M SCULLION
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Credential | FNP-C
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Telephone | 315-303-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | F335656-1
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License Number State | NY
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