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General NPI Number Information
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NPI Number | 1073598561
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Entity Type | Individual
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Provider Name | ELIZABETH ANNE HOGAN MD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 7717 STUYVESANT AVE ANN KLEIN FORENSIC CENTER
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City | WEST TRENTON
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State | NJ
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Zip | 08628-0717
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Country | US
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Telephone | 609-633-0916
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Fax | 609-633-1030
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Provider Business Mailing Address
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Address Line | 7717 STUYVESANT AVE ANN KLEIN FORENSIC CENTER
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City | WEST TRENTON
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State | NJ
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Zip | 08628-0717
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Country | US
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Telephone | 609-633-0916
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Fax | 609-633-1030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | 25MA06864800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA06864800
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License Number State | NJ
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