MEDICARE: MR. VITO PAGANO D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00496700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104823293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VITO PAGANO D.C.

Provider Business Mailing Address
First Line	:	2 TREE FREE RD STE B220
Second Line	:
City	:	PENNINGTON
State	:	NJ
Zip	:	08534
Country	:	US
Telephone Number	:	609-730-1970
Fax Number	:	609-730-1972

Provider Business Practice Location Address
First Line	:	2 TREE FARM RD STE B220
Second Line	:
City	:	PENNINGTON
State	:	NJ
Zip	:	08534-1488
Country	:	US
Telephone Number	:	609-730-1970
Fax Number	:	609-730-1972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/05/2008

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