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1922216258
CAROLYN RENEE TAVARES
ITHACA, NY
NPI
1922216258
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: NY 363370-1)
Enumeration Date
2007-05-18
Last Update Date
2007-07-08
Business Address
-- CAROLYN RENEE TAVARES RN
2192 MECKLENBURG RD
ITHACA, NY 14850-9322
Phone number: 607-256-3617
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Mailing Address
-- CAROLYN RENEE TAVARES RN
2192 MECKLENBURG RD
ITHACA, NY 14850-9322
Phone number: 607-256-3617
Copy
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