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NPI Code Detail

MEDICARE: GENNADY KOGAN

MEDICARE:   GENNADY  KOGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1174767040
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENNADY KOGAN
Provider Business Mailing Address
First Line : 60 BAY 38TH ST
Second Line : APT 2
City : BROOKLYN
State : NY
Zip : 11214-4417
Country : US
Telephone Number : 718-449-0540
Fax Number :
Provider Business Practice Location Address
First Line : 60 BAY 38TH ST
Second Line : APT 2
City : BROOKLYN
State : NY
Zip : 11214-4417
Country : US
Telephone Number : 718-449-0540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2009
Last Update Date : 04/23/2009

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Directions to “ GENNADY KOGAN ” Practice Location

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