Basic Information
| Provider Information | |||||||||
| NPI: | 1891805420 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAGAN | ||||||||
| FirstName: | ANNETTE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 365067 | ||||||||
| Address2: | UPR MEDICAL SCIENCE CAMPUS DEPT OF PSYCHIATRY | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009265067 | ||||||||
| CountryCode: | US | ||||||||
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| FaxNumber: | 7877660940 | ||||||||
| Practice Location | |||||||||
| Address1: | UPR MEDICAL SCIENCE CAMPUS | ||||||||
| Address2: | DEPT OF PSYCHIATRY | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877654047 | ||||||||
| FaxNumber: | 7877660940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 6660 | PR | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.