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NPI 1902538903

NPI 1902538903 : BRANDON BARNOWSKI : WARREN, RI

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General NPI Number Information
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    NPI Number           |    1902538903
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDON BARNOWSKI
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/28/2022
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    Last Update Date     |    06/29/2022
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Provider Practice Location Address
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    Address Line         |    38 BETH AVENUE 
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    City                 |    WARREN
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    State                |    RI
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    Zip                  |    02885
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    Country              |    US
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    Telephone            |    401-487-0779
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    38 BETH AVE 
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    City                 |    WARREN
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    State                |    RI
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    Zip                  |    02885-3713
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    Country              |    US
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    Telephone            |    401-487-0779
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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