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General NPI Number Information
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NPI Number | 1952293623
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Entity Type | Organization
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Legal Business Name | PORTSMOUTH OPCO LLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1610 28TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2641
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Country | US
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Telephone | 718-337-8499
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Fax |
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Provider Business Mailing Address
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Address Line | 2833 SMITH AVE STE 406
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City | BALTIMORE
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State | MD
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Zip | 21209-1426
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Country | US
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Telephone | 718-337-8499
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MOISHE MAYER
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Credential |
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Telephone | 718-337-8499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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