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General NPI Number Information
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NPI Number | 1760770440
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Entity Type | Individual
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Provider Name | CARLOS ALBERTO PAGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 622 W 168TH ST VC14-238
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 646-317-4785
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Fax |
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Provider Business Mailing Address
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Address Line | 445 E 68TH ST APT 7H
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City | NEW YORK
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State | NY
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Zip | 10065-6330
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Country | US
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Telephone | 787-447-5803
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 278525
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License Number State | NY
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