Doctor Name: | KARYN PAGANO |
NPI Number: | 1104940873 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | 011373 |
Business Practice Address: | 1055 Portion Rd Suite 11w Farmingville, NY - 117382299 |
Business Phone Number: | 6317364321 |
Business Fax Number: | 6317364370 |
Mailing Address: | 1055 Portion Rd, Suite 11w FARMINGVILLE |
State: | NY |
Postal Code: | 117382299 |
Phone Number: | 6317364321 |
Fax Number: | 6317364370 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 08/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 011373 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |