Provider Demographics
NPI:1891848032
Name:PAGAN, REBECCA EVE (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:EVE
Last Name:PAGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:EVE
Other - Last Name:SUGERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1015 WASHINGTON AVE
Mailing Address - Street 2:APT.4E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-2459
Mailing Address - Country:US
Mailing Address - Phone:718-941-0807
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016917103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical