Healthcare Provider Details

I. General information

NPI: 1326208166
Provider Name (Legal Business Name): ANNA KOGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 GREENE AVE
BROOKLYN NY
11238
US

IV. Provider business mailing address

333 GREENE AVE
BROOKLYN NY
11238-2295
US

V. Phone/Fax

Practice location:
  • Phone: 718-758-5777
  • Fax: 888-887-9723
Mailing address:
  • Phone: 718-758-5777
  • Fax: 888-879-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number259336
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: