Individual
MR. DWIGHT RANDOLPH MONTFORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
5313 HUDSON AVE, WEST NEW YORK, NJ 07093
(646) 296-8749
Mailing address
179 BENNETT AVE, APT 8G, NEW YORK, NY 10040-4036
(646) 296-8749
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI02451100
NJ
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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