1336863620 NPI number — MRS. MARIA DEL ROSARIO PAGAN PSYCHOLOGIST

Table of content: MRS. MARIA DEL ROSARIO PAGAN PSYCHOLOGIST (NPI 1336863620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336863620 NPI number — MRS. MARIA DEL ROSARIO PAGAN PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAGAN
Provider First Name:
MARIA
Provider Middle Name:
DEL ROSARIO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336863620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PORTALES DE SAN JUAN 1300 CALLE 7
Provider Second Line Business Mailing Address:
APARTMENTO L 194
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00924-4584
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-448-8486
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE PERSEO 501
Provider Second Line Business Practice Location Address:
COND CENTRO DE ATAMIRA SUITE 203
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-675-0663
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  7407 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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