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General NPI Number Information
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NPI Number | 1962661785
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Entity Type | Organization
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Legal Business Name | MARC R IMUNDO MD PC
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 230 HILTON AVE SUITE 107
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone | 516-742-4442
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Fax | 516-505-0768
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Provider Business Mailing Address
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Address Line | 230 HILTON AVE SUITE 107
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone | 516-742-4442
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Fax | 516-505-0768
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARC R IMUNDO
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Credential | M.D.
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Telephone | 516-742-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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