Provider Demographics
NPI:1689987273
Name:PAGANI NEUROLOGICAL INSTITUTE, INC.
Entity Type:Organization
Organization Name:PAGANI NEUROLOGICAL INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PAGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-241-2123
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-241-2123
Mailing Address - Fax:513-241-0417
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-241-2123
Practice Address - Fax:513-241-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64763865OtherKENTUCKY MEDICAID
OH0266313Medicaid
OH615484900OtherUS DEPT OF LABOR
KY64763865OtherKENTUCKY MEDICAID
OH615484900OtherUS DEPT OF LABOR
OH0266313Medicaid