Provider Demographics
NPI:1477535904
Name:PARAGAS, LORI KURGAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:KURGAN
Last Name:PARAGAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 WHITNEY AVE.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517
Mailing Address - Country:US
Mailing Address - Phone:203-288-0129
Mailing Address - Fax:203-288-1858
Practice Address - Street 1:1952 WHITNEY AVE.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517
Practice Address - Country:US
Practice Address - Phone:203-288-0129
Practice Address - Fax:203-288-1858
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000760213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004222345Medicaid
CT008058346Medicaid
CTU90123Medicare UPIN