Provider Demographics
NPI:1851607493
Name:GOVIGNON, RICHARD E JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:GOVIGNON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 STEEPLECHASE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1912
Mailing Address - Country:US
Mailing Address - Phone:732-462-1092
Mailing Address - Fax:
Practice Address - Street 1:4057 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7700
Practice Address - Country:US
Practice Address - Phone:732-493-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02907000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist