Provider Demographics
NPI:1215384367
Name:PAGONA, LINDA (MS ED)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:PAGONA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NEHRING AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2412
Mailing Address - Country:US
Mailing Address - Phone:516-286-0392
Mailing Address - Fax:
Practice Address - Street 1:4012 BERNICE RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1715
Practice Address - Country:US
Practice Address - Phone:516-286-0392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist