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General NPI Number Information
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NPI Number | 1912333857
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Entity Type | Individual
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Provider Name | MARYANN B. ROIK MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 381 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-3018
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Country | US
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Telephone | 203-977-5303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 201
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City | LINCROFT
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State | NJ
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Zip | 07738-0201
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 005691
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License Number State | CT
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