ProviderBusinessMailingAddressFaxNumber = '5855064185'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1477060473
ANSAH
DERICK
OWUSU
601 ELMWOOD AVE BOX 659
ROCHESTER
NY
146420001
1588778393
DICKERSON
KENNETH
ROBERT
601 ELMWOOD AVE
ROCHESTER
NY
146420001
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