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General NPI Number Information
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NPI Number | 1003873241
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Entity Type | Individual
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Provider Name | JANE GAGNE M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 274 3RD ST SUITE 100
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City | BEAVER
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State | PA
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Zip | 15009-2333
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Country | US
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Telephone | 724-774-5700
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Fax | 724-774-5175
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Provider Business Mailing Address
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Address Line | 99 AUTUMN ST SUITE 101
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City | ALIQUIPPA
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State | PA
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Zip | 15001-1301
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Country | US
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Telephone | 724-375-3199
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Fax | 724-375-5858
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD053735L
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License Number State | PA
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