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efta-efta00314245DOJ Data Set 9Other

WEILL CORNELL MEDICAL COLLEGE

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Unknown
Source
DOJ Data Set 9
Reference
efta-efta00314245
Pages
1
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0
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WEILL CORNELL MEDICAL COLLEGE WCMC NEURO SURG SPINE CENTER 59TH ST Patient Name: Patient ID #: Visit #: EPSTEIN,JEFFREY 7604598 Date Received: iiiiiii018 Account ID #: Appointment Provider: HARTL, ROGER Type Amount Source Ref Other $350.00 Credit Card Credit Card Information Card Brand: Card ends with: Transaction ID: Authorization code: Transaction Date : wed Jan 17, 2018 9:31 AM Transaction Type: Payment Received by: GINYARD, DEJENE Thank you for your payment. EFTA00314245

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