Provider Demographics
NPI:1962567180
Name:PAGANO, PARWANE (MD)
Entity type:Individual
Prefix:
First Name:PARWANE
Middle Name:
Last Name:PAGANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 WEST 168TH STREET
Mailing Address - Street 2:PH5-546
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-9876
Mailing Address - Fax:212-342-2139
Practice Address - Street 1:622 WEST 168TH STREET
Practice Address - Street 2:PH5-546
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9876
Practice Address - Fax:212-342-2139
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247525-1207L00000X
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
L69084Medicare ID - Type Unspecified