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General NPI Number Information
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NPI Number | 1922083518
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Entity Type | Organization
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Legal Business Name | PAGANA & PAGANA-DEFAZIO FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1072 MARKET ST
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City | SUNBURY
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State | PA
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Zip | 17801-2403
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Country | US
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Telephone | 570-286-8521
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Fax | 570-286-6197
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Provider Business Mailing Address
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Address Line | 1072 MARKET ST
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City | SUNBURY
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State | PA
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Zip | 17801-2403
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Country | US
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Telephone | 570-286-8521
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Fax | 570-286-6197
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Authorized Official
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Title or Position | FAMILY PRACTITIONER
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Name | DR. JOHN P. PAGANA
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Credential | M.D.
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Telephone | 570-286-8521
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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 |
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License Number State |
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