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NPI Code Detail

MEDICARE: DR. EVAN S KOGAN PH.D.

MEDICARE: DR. EVAN S KOGAN PH.D.
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
1103TC0700XClinical PsychologistPS015611PA

General Provider Information

NPI Number : 1194884593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN S KOGAN PH.D.
Provider Business Mailing Address
First Line : 810 CLAIRTON BLVD STE 500-600
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-5505
Country : US
Telephone Number : 412-650-1100
Fax Number : 412-650-1101
Provider Business Practice Location Address
First Line : 810 CLAIRTON BLVD STE 500-600
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-5505
Country : US
Telephone Number : 412-650-1100
Fax Number : 412-650-1101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 11/12/2020

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Directions to “ DR. EVAN S KOGAN PH.D.” Practice Location

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