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General NPI Number Information
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NPI Number | 1902863483
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Entity Type | Individual
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Provider Name | RAYMOND ORTIZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 8 MAPLE AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-8722
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Country | US
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Telephone | 631-968-0586
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Fax | 631-968-6720
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Provider Business Mailing Address
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Address Line | 80 EASY ST
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City | WEST SAYVILLE
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State | NY
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Zip | 11796-1236
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Country | US
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Telephone | 516-607-5603
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | XOO6695-1
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License Number State | NY
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