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General NPI Number Information
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NPI Number | 1962651729
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Entity Type | Organization
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Legal Business Name | VINCENTE M. SIMONCINI, OD PC
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 820 BESTGATE RD SUITE 1C
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3404
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Country | US
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Telephone | 410-266-0001
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Fax | 410-266-3988
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Provider Business Mailing Address
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Address Line | 820 BESTGATE RD SUITE 1C
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3404
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Country | US
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Telephone | 410-266-0001
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Fax | 410-266-3988
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Authorized Official
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Title or Position | OWNER
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Name | DR. VINCENTE MARIO SIMONCINI
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Credential | O.D.
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Telephone | 410-266-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA 1018
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License Number State | MD
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