Provider Demographics
NPI:1386482867
Name:PAEZ, KATARENA NICOLE (PA-S)
Entity type:Individual
Prefix:
First Name:KATARENA
Middle Name:NICOLE
Last Name:PAEZ
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 SIENA WAY
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-8663
Mailing Address - Country:US
Mailing Address - Phone:609-501-3239
Mailing Address - Fax:
Practice Address - Street 1:3441 SIENA WAY
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8663
Practice Address - Country:US
Practice Address - Phone:609-501-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program