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1528217767
DEWITT RANDOLPH SCOTT
SUFFERN, NY
NPI
1528217767
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 000779)
Enumeration Date
2008-09-11
Last Update Date
2008-09-11
Business Address
Mr. DEWITT RANDOLPH SCOTT RPA
5A ETHAN ALLEN DR
SUFFERN, NY 10901-1802
Phone number: 845-548-6567
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Mailing Address
Mr. DEWITT RANDOLPH SCOTT RPA
8931 161ST ST
JAMAICA, NY 11432-6102
Phone number: 845-548-6567
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