| Doctor Name: | MS. MARY ELLEN PAGNOZZI |
| NPI Number: | 1114943214 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.P.R.N. |
| License Number: | 001588 |
| Business Practice Address: | 3 Heron Rd Mystic, CT - 063553253 |
| Business Phone Number: | 8605366442 |
| Business Fax Number: | 8605366442 |
| Mailing Address: | 3 Heron Rd, MYSTIC |
| State: | CT |
| Postal Code: | 063553253 |
| Phone Number: | 8605366442 |
| Fax Number: | 8605366442 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 12/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 001588 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |