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General NPI Number Information
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NPI Number | 1598916223
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Entity Type | Individual
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Provider Name | LEON MICHAEL KOGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 400 W MAIN ST STE 300
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City | BABYLON
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State | NY
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Zip | 11702-3019
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Country | US
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Telephone | 631-321-6400
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Fax | 631-321-2969
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS RD STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5792
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Country | US
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Telephone | 732-807-0877
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Fax | 201-751-1680
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 15962
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | NJ 25MA09015600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 240404
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License Number State | NY
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