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NPI 1912568536

NPI 1912568536 : ROKHEL KAZIYEV OD : CORONA, NY

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General NPI Number Information
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    NPI Number           |    1912568536
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    Entity Type          |    Individual 
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    Provider Name        |    ROKHEL KAZIYEV OD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/25/2019
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    Last Update Date     |    06/25/2019
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Provider Practice Location Address
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    Address Line         |    10306 ROOSEVELT AVE 
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    City                 |    CORONA
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    State                |    NY
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    Zip                  |    11368-2330
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    Country              |    US
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    Telephone            |    718-424-1333
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9918 66TH AVE APT 5A 
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    City                 |    REGO PARK
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    State                |    NY
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    Zip                  |    11374-3633
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    TUV008979
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    License Number State |    NY
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