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General NPI Number Information
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NPI Number | 1972650430
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Entity Type | Individual
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Provider Name | PATRICIA A YOUNGQUIST OD
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 185 BOSTON POST RD
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City | ORANGE
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State | CT
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Zip | 06477-3200
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Country | US
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Telephone | 205-795-5000
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Fax | 203-795-6685
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Provider Business Mailing Address
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Address Line | 1950 OLD GALLOWS RD STE 520
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City | VIENNA
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State | VA
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Zip | 22182-3970
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Country | US
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Telephone | 38-478-8997
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Fax | 571-223-6780
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2200
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License Number State | CT
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