Provider Demographics
NPI:1063843035
Name:ASHFORD GASTROENTEROLOGY SERVICES
Entity Type:Organization
Organization Name:ASHFORD GASTROENTEROLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGANI
Authorized Official - Suffix:
Authorized Official - Credentials:9146
Authorized Official - Phone:787-725-7405
Mailing Address - Street 1:29 CALLE WASHINGTON
Mailing Address - Street 2:506
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1510
Mailing Address - Country:US
Mailing Address - Phone:787-725-4705
Mailing Address - Fax:787-725-4705
Practice Address - Street 1:29 CALLE WASHINGTON STE 506
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1521
Practice Address - Country:US
Practice Address - Phone:787-725-4705
Practice Address - Fax:787-725-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy