Individual
DR. JEAN MARIE PAGANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
(215) 276-6167
Mailing address
105 PARKVIEW CIR, MEDIA, PA 19063-6318
(610) 566-3903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
I3-0001187
DE
152W00000X
Optometrist
Primary
OEG001178
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00061991
RAILROAD MEDICARE
PA
05
—
0011944190003
—
PA
01
—
0115840000
KHPE
PA
01
—
2248
AETNA HMO
PA
01
—
539951
BLUE SHIELD
PA
Enumeration date
09/27/2006
Last updated
12/04/2019
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