Healthcare Provider Details

I. General information

NPI: 1033060934
Provider Name (Legal Business Name): CONOR HOGAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TOWN SQUARE PL STE 1238
JERSEY CITY NJ
07310-1810
US

IV. Provider business mailing address

111 TOWN SQUARE PL STE 1238 PMB 778956
JERSEY CITY NJ
07310-1810
US

V. Phone/Fax

Practice location:
  • Phone: 646-240-1693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00761900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: