Provider Demographics
NPI:1184620833
Name:PAGANO, STEVE ROBERT JR (DC)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ROBERT
Last Name:PAGANO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:CARROLLTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15722-0646
Mailing Address - Country:US
Mailing Address - Phone:814-344-8740
Mailing Address - Fax:814-344-8748
Practice Address - Street 1:204 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CARROLLTOWN
Practice Address - State:PA
Practice Address - Zip Code:15722-0646
Practice Address - Country:US
Practice Address - Phone:814-344-8740
Practice Address - Fax:814-344-8748
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007074-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017164600006Medicaid
PA0017164600006Medicaid
PAU73279Medicare UPIN