Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD431028 | PA |
N | 2080A0000X | Adolescent Medicine | MD431028 | PA |
NPI | 1003934613 |
---|---|
Provider Name | Mary Pagnotto |
First Address | Wexford, PA 15090-9303 |
Second Address | Moon Township, PA 15108-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 07/04/2021 |