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General NPI Number Information
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NPI Number | 1104940873
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Entity Type | Individual
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Provider Name | KARYN PAGANO P.A.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 1055 PORTION RD SUITE 11W
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City | FARMINGVILLE
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State | NY
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Zip | 11738-2299
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Country | US
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Telephone | 631-736-4321
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Fax | 631-736-4370
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Provider Business Mailing Address
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Address Line | 1055 PORTION RD SUITE 11W
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City | FARMINGVILLE
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State | NY
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Zip | 11738-2299
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Country | US
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Telephone | 631-736-4321
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Fax | 631-736-4370
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 011373
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License Number State | NY
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