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NPI 1790067775

NPI 1790067775 : VENUS M MIGNOGNI R.PH : BERKELEY HEIGHTS, NJ

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General NPI Number Information
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    NPI Number           |    1790067775
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    Entity Type          |    Individual 
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    Provider Name        |    VENUS M MIGNOGNI R.PH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/15/2011
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    Last Update Date     |    07/01/2016
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Provider Practice Location Address
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    Address Line         |    1 DIAMOND HILL RD 
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    City                 |    BERKELEY HEIGHTS
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    State                |    NJ
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    Zip                  |    07922-2104
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    Country              |    US
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    Telephone            |    908-673-7190
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    Fax                  |    908-673-7396
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Provider Business Mailing Address
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    Address Line         |    17 PIHLMAN PL 
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    City                 |    CHATHAM
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    State                |    NJ
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    Zip                  |    07928-2706
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    Country              |    US
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    Telephone            |    973-635-4515
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    Fax                  |    908-673-7396
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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       |    28RIO2131600
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    License Number State |    NJ
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