Provider Demographics
NPI:1447454855
Name:CARMEN J. CAGNO DMD, INC.
Entity type:Organization
Organization Name:CARMEN J. CAGNO DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ZEIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-946-2999
Mailing Address - Street 1:1 FAIRHILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1174
Mailing Address - Country:US
Mailing Address - Phone:724-658-2055
Mailing Address - Fax:724-656-1445
Practice Address - Street 1:1 FAIRHILL DRIVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1174
Practice Address - Country:US
Practice Address - Phone:724-658-2055
Practice Address - Fax:724-656-1445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037146251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7448350001Medicare NSC