Healthcare Provider Details

I. General information

NPI: 1477226793
Provider Name (Legal Business Name): PRAGYA PAPAGANTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

897 W MAIN ST
DOVER FOXCROFT ME
04426-1029
US

IV. Provider business mailing address

474 ARLENE ST
STATEN ISLAND NY
10314-3814
US

V. Phone/Fax

Practice location:
  • Phone: 207-564-8401
  • Fax:
Mailing address:
  • Phone: 419-309-8331
  • Fax: 419-309-8331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD30269
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: