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General NPI Number Information
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NPI Number | 1891428520
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Entity Type | Individual
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Provider Name | ERIC VICTOR PAGANO OTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/09/2022
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 400 ENTERPRISE DR FL 2
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City | ROYERSFORD
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State | PA
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Zip | 19468-1218
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Country | US
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Telephone | 800-321-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 CORNING RD
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City | PALM
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State | PA
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Zip | 18070-1019
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Country | US
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Telephone | 856-873-2043
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR01066700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC020677
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License Number State | PA
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