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General NPI Number Information
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NPI Number | 1942570577
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Entity Type | Organization
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Legal Business Name | MANUEL VELOSO PC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 303 E PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-3600
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Country | US
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Telephone | 516-431-2828
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Fax | 516-431-3747
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Provider Business Mailing Address
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Address Line | 303 E PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-3600
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Country | US
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Telephone | 516-431-2828
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Fax | 516-431-3747
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANUEL A VELOSO JR.
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Credential |
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Telephone | 516-431-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 111634
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License Number State | NY
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