MEDICARE: ROBERT P HOGAN D.O. P.C.

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
1	207R00000X	Internal Medicine Physician	MB51299	NJ

General Provider Information

NPI Number	:	1396708632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT P HOGAN D.O. P.C.

Provider Business Mailing Address
First Line	:	1230 PARKWAY AVE
Second Line	:
City	:	WEST TRENTON
State	:	NJ
Zip	:	08628
Country	:	US
Telephone Number	:	609-883-5454
Fax Number	:	609-883-2565

Provider Business Practice Location Address
First Line	:	1230 PARKWAY AVE STE 203
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-3018
Country	:	US
Telephone Number	:	609-883-5454
Fax Number	:	609-882-2565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	05/18/2021

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