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General NPI Number Information
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NPI Number | 1700135506
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Entity Type | Individual
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Provider Name | VINCENT MICHAEL HOGAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 66 EAST 79TH ST.
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 212-249-5499
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Fax |
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Provider Business Mailing Address
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Address Line | 1077 ALSTON ROAD
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City | MONTECITO
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State | CA
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Zip | 93108-0000
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Country | US
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Telephone | 805-565-4839
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Fax | 805-565-4669
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 087021
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License Number State | NY
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