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General NPI Number Information
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NPI Number | 1912042748
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Entity Type | Individual
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Provider Name | DR. SHEILA CIPOLLA
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 12/08/2007
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Provider Practice Location Address
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Address Line | 1103 STEWART AVE SUITE 110
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City | GARDEN CITY
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State | NY
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Zip | 11530-4886
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Country | US
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Telephone | 516-745-0688
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 AVALON SQ
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City | GLEN COVE
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State | NY
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Zip | 11542-2845
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Country | US
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Telephone | 516-801-3789
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 051689-1
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License Number State | NY
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