Individual
JESSICA BARBARA PAGANA-DEFAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1072 MARKET ST, SUNBURY, PA 17801-2458
(570) 286-8521
(570) 286-6197
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS012175
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018921720001
—
PA
01
—
745913
MEDICARE PTAN
PA
Enumeration date
09/23/2005
Last updated
01/28/2019
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