ProviderBusinessMailingAddressFaxNumber = '3157862074'

NPI	LastName	FirstName	MidName	Organization	Mailing Address	City	State	Zip
1447229869	LICZNERSKI	ADAM	BOGDAN		826 WASHINGTON ST	WATERTOWN	NY	136014065
1407825151	LICZNERSKI	BARBARA	TERESA		826 WASHINGTON ST	WATERTOWN	NY	136014065

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