Provider Demographics
NPI:1447611876
Name:PAGAN, GABRIEL EMIL (PSYD, PASSII)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:EMIL
Last Name:PAGAN
Suffix:
Gender:M
Credentials:PSYD, PASSII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA SAN ANDRES
Mailing Address - Street 2:SUITE 209, AVE. HOSTOS
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5704
Mailing Address - Country:US
Mailing Address - Phone:787-652-1527
Mailing Address - Fax:
Practice Address - Street 1:VILLA SAN ANDRES
Practice Address - Street 2:CS UNITE 209, AVE. HOSTOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5704
Practice Address - Country:US
Practice Address - Phone:787-432-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-12
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5846103TC0700X
PR917101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)