Provider Demographics
NPI:1336547116
Name:PAGANI, LORI (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:PAGANI
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 MCKEEL ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-5005
Mailing Address - Country:US
Mailing Address - Phone:914-962-1107
Mailing Address - Fax:
Practice Address - Street 1:1306 MCKEEL ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-5005
Practice Address - Country:US
Practice Address - Phone:914-962-1107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004319-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist