Provider Demographics
NPI:1003942590
Name:PAGANO, JOHN V (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:V
Last Name:PAGANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870-1015
Mailing Address - Country:US
Mailing Address - Phone:607-962-3578
Mailing Address - Fax:
Practice Address - Street 1:24 S BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2257
Practice Address - Country:US
Practice Address - Phone:607-936-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist