Provider Demographics
NPI:1821163643
Name:PAKONIS, FIONA (MD)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:
Last Name:PAKONIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FIONA
Other - Middle Name:
Other - Last Name:SANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:121 CENTER GROVE RD STE 15
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4453
Mailing Address - Country:US
Mailing Address - Phone:973-361-4900
Mailing Address - Fax:973-361-1842
Practice Address - Street 1:121 CENTER GROVE RD STE 15
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4453
Practice Address - Country:US
Practice Address - Phone:973-361-4900
Practice Address - Fax:973-361-1842
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08116600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics