Provider Demographics
NPI:1073213633
Name:PAGADUAN, JAMES EARL (APN)
Entity Type:Individual
Prefix:
First Name:JAMES EARL
Middle Name:
Last Name:PAGADUAN
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HOME PL
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1708
Mailing Address - Country:US
Mailing Address - Phone:201-556-8486
Mailing Address - Fax:
Practice Address - Street 1:41 HOME PL
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1708
Practice Address - Country:US
Practice Address - Phone:201-556-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13808800163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ01450900OtherAMERICAN NURSES CREDENTIALING CENTER