Provider Demographics
NPI:1992997340
Name:PAGOYO, NICOLE J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:J
Last Name:PAGOYO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:J
Other - Last Name:PATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3375 KOAPAKA ST STE D108
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1865
Mailing Address - Country:US
Mailing Address - Phone:808-831-5873
Mailing Address - Fax:808-831-5888
Practice Address - Street 1:3375 KOAPAKA ST STE D108
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1865
Practice Address - Country:US
Practice Address - Phone:808-831-5873
Practice Address - Fax:808-831-5888
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14192183500000X
HI2678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist