Provider Demographics
NPI:1134646854
Name:PAGAN, SHARON Y (ANP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:Y
Last Name:PAGAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:Y
Other - Last Name:PAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:38 MEADOWLANDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2925
Mailing Address - Country:US
Mailing Address - Phone:201-210-2870
Mailing Address - Fax:
Practice Address - Street 1:38 MEADOWLANDS PKWY
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2925
Practice Address - Country:US
Practice Address - Phone:201-210-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJF1216358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily