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General NPI Number Information
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NPI Number | 1992963482
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Entity Type | Individual
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Provider Name | EVAN GOREN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 701 N BROADWAY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-1020
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Country | US
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Telephone | 914-428-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 303 SOUTH BROADWAY SUITE 034
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City | TARRYTOWN
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State | NY
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Zip | 10591-5410
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Country | US
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Telephone | 914-366-6161
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Fax | 914-366-6101
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 260419
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License Number State | NY
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