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NPI 1972536613

NPI 1972536613 : NOEL A. ZEH ATC, CSCS : BINGHAMTON, NY

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General NPI Number Information
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    NPI Number           |    1972536613
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    Entity Type          |    Individual 
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    Provider Name        |    NOEL A. ZEH ATC, CSCS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/08/2006
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    Last Update Date     |    04/13/2016
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Provider Practice Location Address
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    Address Line         |    4000 VESTAL PARKWAY E 
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    City                 |    BINGHAMTON
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    State                |    NY
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    Zip                  |    13902
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    Country              |    US
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    Telephone            |    607-777-2989
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    521 SWARTWOOD AVE 
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    City                 |    ENDICOTT
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    State                |    NY
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    Zip                  |    13760-4543
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    Country              |    US
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    Telephone            |    607-748-2191
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    25MT00114800
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    License Number State |    NJ
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