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Johanna C. Figueroa, M.D. 216 Mineral Ave/ Willis Ave Roslyn Heights, NY 11577Urology and Pelvic Health Tel #: (516) 3992501 Fax #: (516) 3992504PATIENT INFORMATION: PATIENT NAME: STREET ADDRESS:
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Johanna C is a specific tax form used for reporting certain income or financial information to the authorities.
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