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General NPI Number Information
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NPI Number | 1902050289
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Entity Type | Individual
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Provider Name | FABIOLA M ROMO REATEGUI MS SLP / TSLD BIL
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Gender | Female
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 07/23/2011
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Provider Practice Location Address
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Address Line | 717 TUCKAHOE RD APT 4B
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City | YONKERS
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State | NY
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Zip | 10710-5251
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Country | US
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Telephone | 718-908-4121
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Fax |
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Provider Business Mailing Address
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Address Line | 717 TUCKAHOE RD APT 4B
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City | YONKERS
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State | NY
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Zip | 10710-5251
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Country | US
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Telephone | 718-908-4121
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0160721
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License Number State | NY
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