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General NPI Number Information
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NPI Number | 1912150996
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Entity Type | Individual
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Provider Name | ELIZABETH ANN HOGAN MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 81 BEAVER SPUR APT 18
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City | MORICHES
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State | NY
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Zip | 11955-1215
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Country | US
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Telephone | 631-335-4340
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1023
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City | MANORVILLE
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State | NY
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Zip | 11949-0016
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Country | US
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Telephone | 631-335-4340
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 015366
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License Number State | NY
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