Provider Demographics
NPI:1588968739
Name:MAIGNAN, SAGINE FLORNA (PA-C)
Entity type:Individual
Prefix:
First Name:SAGINE
Middle Name:FLORNA
Last Name:MAIGNAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2475 SAINT RAYMONDS AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3124
Mailing Address - Country:US
Mailing Address - Phone:845-565-3700
Mailing Address - Fax:845-565-3308
Practice Address - Street 1:484 TEMPLE HILL RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5557
Practice Address - Country:US
Practice Address - Phone:845-565-3700
Practice Address - Fax:845-565-3308
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY626340-1163WS0200X
NY020344363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No163WS0200XNursing Service ProvidersRegistered NurseSchool