MEDICARE: ELIZABETH PAGAN

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	235Z00000X	Speech-Language Pathologist	58 015550	NY

General Provider Information

NPI Number	:	1649494659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PAGAN

Provider Business Mailing Address
First Line	:	3 EMERSON CT
Second Line	:
City	:	KATONAH
State	:	NY
Zip	:	10536-3156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 BOCES DR
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4321
Country	:	US
Telephone Number	:	914-245-2700
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	11/28/2023

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