Doctor Name: | DR. MARC ROBERT PAGANO |
NPI Number: | 1457560054 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 3320 |
Business Practice Address: | 11528 Royalton Rd Suite 101 North Royalton, OH - 441334469 |
Business Phone Number: | 4405823310 |
Business Fax Number: | 4405823310 |
Mailing Address: | 11528 Royalton Rd, Suite 101 NORTH ROYALTON |
State: | OH |
Postal Code: | 441334469 |
Phone Number: | 4405823310 |
Fax Number: | 4405823310 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 04/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |