Healthcare Provider Details

I. General information

NPI: 1538152905
Provider Name (Legal Business Name): FRANCESCO P PAGANO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 MARKET ST
SADDLE BROOK NJ
07663-5316
US

IV. Provider business mailing address

108 CHESHIRE LN
RINGWOOD NJ
07456-2743
US

V. Phone/Fax

Practice location:
  • Phone: 201-368-1717
  • Fax: 201-368-9618
Mailing address:
  • Phone: 973-556-5464
  • Fax: 201-368-9618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB048581
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: