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Individual
NIDIA MERCEDES BAZANTE
Active
Individual
NIDIA MERCEDES BAZANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P103183
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103183-01
LIMITED PERMIT
NY
Enumeration date
11/12/2019
Last updated
01/07/2020
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