Provider Demographics
NPI:1700899549
Name:ANDREW PAGNOTTA DCPC
Entity Type:Organization
Organization Name:ANDREW PAGNOTTA DCPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PAGNOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-341-5954
Mailing Address - Street 1:101 CHELSEA AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08741-1409
Mailing Address - Country:US
Mailing Address - Phone:732-341-5954
Mailing Address - Fax:732-341-5955
Practice Address - Street 1:101 CHELSEA AVE
Practice Address - Street 2:
Practice Address - City:PINE BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08741-1409
Practice Address - Country:US
Practice Address - Phone:732-341-5954
Practice Address - Fax:732-341-5955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty