Provider Demographics
NPI:1336484880
Name:PAGANO, KRISTINE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:PAGANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W 83RD ST
Mailing Address - Street 2:APT 18
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5076
Mailing Address - Country:US
Mailing Address - Phone:614-935-9694
Mailing Address - Fax:
Practice Address - Street 1:155 W 83RD ST
Practice Address - Street 2:APT 18
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5076
Practice Address - Country:US
Practice Address - Phone:614-935-9694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY643066163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse