Individual
INEZ L PAGNOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
315 S MANNING BLVD, ALBANY, NY 12208-1707
(518) 525-1550
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
155330
NY
208M00000X
Hospitalist Physician
Primary
155330
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00888197
—
NY
01
—
080185005
RR MEDICARE
NY
05
—
2100371
—
MA
Enumeration date
09/12/2005
Last updated
06/01/2021
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