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General NPI Number Information
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NPI Number | 1952727331
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Entity Type | Organization
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Legal Business Name | R.E. CHIROPRACTIC SERVICES, PLLC
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 139-39 35TH AVE. SUITE CFB
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City | FLUSHING
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State | NY
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Zip | 11354-3500
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Country | US
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Telephone | 516-526-2793
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Fax | 718-709-5913
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Provider Business Mailing Address
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Address Line | 6 JULIA CIR
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City | MIDDLE ISLAND
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State | NY
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Zip | 11953-2652
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Country | US
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Telephone | 516-526-2793
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Fax | 718-709-5913
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | DR. RICHARD FREDRICK EBBRECHT
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Credential | MONICA KIM
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Telephone | 646-732-2758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010189-1
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License Number State | NY
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