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General NPI Number Information
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NPI Number | 1316072481
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Entity Type | Individual
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Provider Name | NICHOLAS JOSEPH PAGANO JR. DPM
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 1000 GERMANTOWN PIKE STE J4
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-2489
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Country | US
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Telephone | 215-681-1987
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 GERMANTOWN PIKE STE J4
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-2489
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Country | US
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Telephone | 484-681-9485
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Fax | 484-681-9487
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC005966
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License Number State | PA
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