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General NPI Number Information
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NPI Number | 1992019707
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Entity Type | Individual
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Provider Name | MA. LARISSA FRANCISCO PT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 1733 N OCEAN AVE STE B
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City | MEDFORD
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State | NY
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Zip | 11763-2606
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Country | US
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Telephone | 631-654-1120
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Fax |
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Provider Business Mailing Address
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Address Line | 40 FAIRFIELD WAY APT 9
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City | COMMACK
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State | NY
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Zip | 11725-3417
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 029066-2
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License Number State | NY
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