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General NPI Number Information
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NPI Number | 1972567675
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Entity Type | Individual
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Provider Name | CHINMAYEE BANERJI MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1118 W MERCURY BLVD
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City | HAMPTON
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State | VA
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Zip | 23666-3328
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Country | US
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Telephone | 757-276-9526
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Fax | 877-487-2116
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Provider Business Mailing Address
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Address Line | 4700 MILLENIA BLVD STE 650
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City | ORLANDO
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State | FL
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Zip | 32839-6013
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Country | US
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Telephone | 407-447-7120
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101053502
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License Number State | VA
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