Provider Demographics
NPI:1659723658
Name:PANGILINAN, JOANA
Entity Type:Individual
Prefix:
First Name:JOANA
Middle Name:
Last Name:PANGILINAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8712 56TH AVE
Mailing Address - Street 2:1 FL
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4832
Mailing Address - Country:US
Mailing Address - Phone:347-403-6883
Mailing Address - Fax:
Practice Address - Street 1:8712 56TH AVE
Practice Address - Street 2:1 FL
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4832
Practice Address - Country:US
Practice Address - Phone:347-403-6883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist