Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 10,769 | PR |
NPI | 1033277892 |
---|---|
Provider Name | Dr. Rocio C Mandry-Pagan |
First Address | San Juan, PR 00936-0867 |
Second Address | Guaynabo, PR 00966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G40345 | (02) |