Provider Demographics
NPI:1477559797
Name:PAGANO, LUIGI G (DC)
Entity Type:Individual
Prefix:
First Name:LUIGI
Middle Name:G
Last Name:PAGANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8345 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2376
Mailing Address - Country:US
Mailing Address - Phone:330-373-0800
Mailing Address - Fax:330-378-0801
Practice Address - Street 1:8345 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2376
Practice Address - Country:US
Practice Address - Phone:330-373-0800
Practice Address - Fax:330-378-0801
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8247111N00000X
OHDC3976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381837300Medicaid
V02171Medicare UPIN
FL89352AMedicare PIN
FL4304501Medicare PIN