Provider Demographics
NPI:1659837235
Name:PAGSUGUIRON, MARIA JOVIE (NP-C)
Entity type:Individual
Prefix:MISS
First Name:MARIA JOVIE
Middle Name:
Last Name:PAGSUGUIRON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:JOVIE
Other - Last Name:PAGSUGUIRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-670-1180
Mailing Address - Fax:718-732-1553
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1180
Practice Address - Fax:718-732-1553
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308739363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty