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General NPI Number Information
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NPI Number | 1205188992
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Entity Type | Individual
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Provider Name | MOLLY HOGAN MD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 480 RED HILL RD
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-3052
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Country | US
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Telephone | 908-577-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 625 1ST ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-4101
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Country | US
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Telephone | 908-577-7960
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA10407100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 271502
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License Number State | NY
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