MEDICARE: DR. JOHN A PAGNOZZI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	028396	CT
2	208C00000X	Colon & Rectal Surgery Physician	028396	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	010028396CT04	OTHER	CT	BCBS
3	110029291	OTHER	CT	RAILROAD

General Provider Information

NPI Number	:	1598864563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A PAGNOZZI MD

Provider Business Mailing Address
First Line	:	86 NEW LONDON TPKE
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2616
Country	:	US
Telephone Number	:	860-887-6753
Fax Number	:	860-887-7737

Provider Business Practice Location Address
First Line	:	86 NEW LONDON TPKE
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-2616
Country	:	US
Telephone Number	:	860-887-6753
Fax Number	:	860-887-7737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	03/05/2009

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Directions to “ DR. JOHN A PAGNOZZI MD” Practice Location

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