Basic Information
Provider Information
NPI: 1902871593
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAGLIA
FirstName: MICHAEL
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 178222920
CountryCode: US
TelephoneNumber: 5702718160
FaxNumber: 5702149029
Practice Location
Address1: 190 WELLES ST
Address2:  
City: KINGSTON
State: PA
PostalCode: 187044968
CountryCode: US
TelephoneNumber: 5707141099
FaxNumber: 5707141116
Other Information
ProviderEnumerationDate: 02/17/2006
LastUpdateDate: 08/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101XMD11924RIN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
207V00000XMD438751PAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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