MEDICARE: DRS STEVEN M EMMETT AND BORIS KOGAN PARTNERS

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	208000000X	Pediatrics Physician	162552	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1669431722	OTHER	NY	NPI

General Provider Information

NPI Number	:	1750464509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS STEVEN M EMMETT AND BORIS KOGAN PARTNERS

Provider Business Mailing Address
First Line	:	3104 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4209
Country	:	US
Telephone Number	:	718-339-5544
Fax Number	:	718-339-4892

Provider Business Practice Location Address
First Line	:	3104 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4209
Country	:	US
Telephone Number	:	718-339-5544
Fax Number	:	718-339-4892

Authorized Official
Title or Position	:	PARTNERS
Name	:	DR. BORIS KOGAN
Credential	:	MD
Telephone Number	:	718-339-5544

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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