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General NPI Number Information
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NPI Number | 1972194215
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Entity Type | Organization
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Legal Business Name | SKYHEART MEDICAL LLC
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1126 DICKINSON ST
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City | ELIZABETH
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State | NJ
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Zip | 07201-2404
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Country | US
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Telephone | 973-343-5660
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Fax | 833-978-0843
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Provider Business Mailing Address
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Address Line | 634 EAGLE ROCK AVE UNIT 202
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City | WEST ORANGE
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State | NJ
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Zip | 07052-6801
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Country | US
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Telephone | 973-343-5660
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Fax | 833-978-0843
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Authorized Official
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Title or Position | NP/OWNER
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Name | DR. DEBBIE Y MOHAMMED
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Credential | NP
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Telephone | 973-343-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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