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NPI 1962794644

NPI 1962794644 : MARY LOUISE VECCHIO MS : KENMORE, NY

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General NPI Number Information
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    NPI Number           |    1962794644
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    Entity Type          |    Individual 
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    Provider Name        |    MARY LOUISE VECCHIO MS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/12/2011
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    Last Update Date     |    07/23/2013
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Provider Practice Location Address
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    Address Line         |    2900 DELAWARE AVE 
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    City                 |    KENMORE
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    State                |    NY
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    Zip                  |    14217-2309
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    Country              |    US
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    Telephone            |    716-871-9885
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2900 DELAWARE AVE 
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    City                 |    KENMORE
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    State                |    NY
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    Zip                  |    14217-2309
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    Country              |    US
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    Telephone            |    716-871-9885
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    002430
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    237600000X
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    Taxonomy Name        |    Audiologist-Hearing Aid Fitter
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    License Number       |    14000006384
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    License Number State |    NY
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