Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 12931 | PR |
NPI | 1003940149 |
---|---|
Provider Name | Dr. Yanira L Pagan |
First Address | San Juan, PR 00926 |
Second Address | San Juan, PR 00912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12931 | PHYSICIAN LICENSE (01) | PR |