ProviderBusinessMailingAddressFaxNumber = '3157242966'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1629309281
MORAT
SHAUNA
8181 SENECA TPKE
CLINTON
NY
133231100
1902138019
TIMIAN
MARYBETH
3051 MOHAWK ST
SAUQUOIT
NY
134562907
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