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General NPI Number Information
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NPI Number | 1285740837
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Entity Type | Individual
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Provider Name | COREEN RENEE MONTAGNA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 205 PARK CLUB LN
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City | BUFFALO
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State | NY
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Zip | 14221-5239
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Country | US
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Telephone | 716-857-6243
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Fax | 716-857-6336
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Provider Business Mailing Address
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Address Line | 146 JAMESTOWN RD
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City | GRAND ISLAND
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State | NY
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Zip | 14072-3209
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Country | US
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Telephone | 716-773-8940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 048659
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License Number State | NY
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