Provider Demographics
NPI:1770699365
Name:PAGGIOLI, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:PAGGIOLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W TOWN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2131
Mailing Address - Country:US
Mailing Address - Phone:860-885-0333
Mailing Address - Fax:860-885-1319
Practice Address - Street 1:190 W TOWN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2131
Practice Address - Country:US
Practice Address - Phone:860-885-0333
Practice Address - Fax:860-885-1319
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035017207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001350173Medicaid
CT010035017CT02OtherBLUE CROSS
CT2424240OtherAETNA USHEALTHCARE
CTP2176298OtherOXFORD
CT035017OtherCONNECTICARE
CT7135534005OtherCIGNA
CT0V7409OtherHEALTHNET
CT035017OtherCONNECTICARE
CTG22951Medicare UPIN