Provider Demographics
NPI:1598864563
Name:PAGNOZZI, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:PAGNOZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 NEW LONDON TPKE
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2616
Mailing Address - Country:US
Mailing Address - Phone:860-887-6753
Mailing Address - Fax:860-887-7737
Practice Address - Street 1:86 NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2616
Practice Address - Country:US
Practice Address - Phone:860-887-6753
Practice Address - Fax:860-887-7737
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028396208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001283960Medicaid
CT010028396CT04OtherBCBS
CT110029291OtherRAILROAD
CT110029291OtherRAILROAD
CT001283960Medicaid