Provider Demographics
NPI:1942855747
Name:PAGSANJAN, VERONIKA ANATOLYEVNA (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:VERONIKA
Middle Name:ANATOLYEVNA
Last Name:PAGSANJAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3700 PARK EAST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4339
Mailing Address - Country:US
Mailing Address - Phone:216-593-7180
Mailing Address - Fax:216-593-7499
Practice Address - Street 1:3700 PARK EAST DR STE 100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4339
Practice Address - Country:US
Practice Address - Phone:216-593-7180
Practice Address - Fax:216-593-7499
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily