Provider Demographics
NPI:1659338119
Name:PAGANO, DONNA MCGARITY (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MCGARITY
Last Name:PAGANO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:WILLETTE
Other - Last Name:MCGARITY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:100 OKATIE CENTER BLVD N
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-3750
Mailing Address - Country:US
Mailing Address - Phone:843-547-4058
Mailing Address - Fax:843-705-7411
Practice Address - Street 1:100 OKATIE CENTER BLVD N
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-547-4058
Practice Address - Fax:843-705-7411
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8157OtherMEDICARE PTAN
SC8157OtherMEDICARE PTAN