Healthcare Provider Details

I. General information

NPI: 1992387948
Provider Name (Legal Business Name): JOAN FRANCES P PAGADUAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 AMSTERDAM AVE
NEW YORK NY
10025-1715
US

IV. Provider business mailing address

1060 AMSTERDAM AVE
NEW YORK NY
10025-1715
US

V. Phone/Fax

Practice location:
  • Phone: 212-316-7700
  • Fax:
Mailing address:
  • Phone: 212-316-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number710925
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: