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Individual

JANE GAGNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
274 3RD ST, SUITE 100, BEAVER, PA 15009-2333
(724) 774-5700
(724) 774-5175
Mailing address
99 AUTUMN ST, SUITE 101, ALIQUIPPA, PA 15001-1301
(724) 375-3199
(724) 375-5858

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD053735L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015218350003
PA
05
0144016
OH
01
204249
UPMC
PA
01
786537
BLUE SHIELD
PA
Enumeration date
05/01/2006
Last updated
04/17/2008
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