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General NPI Number Information
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NPI Number | 1942346606
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Entity Type | Individual
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Provider Name | KIANA KAYMANESH O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 200 GREAT RD SUITE 6A
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City | BEDFORD
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State | MA
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Zip | 01730-2711
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Country | US
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Telephone | 781-275-1828
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Fax |
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Provider Business Mailing Address
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Address Line | 18 LANDMARK RD
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City | WESTFORD
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State | MA
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Zip | 01886-4426
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Country | US
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Telephone | 617-755-5707
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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 | 4184
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License Number State | MA
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