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NPI Code Detail

MEDICARE: KAMILLA KOGAN PHARM.D.

MEDICARE: KAMILLA KOGAN PHARM.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
1183500000XPharmacist28RI03508400NJ

General Provider Information

NPI Number : 1831447135
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMILLA KOGAN PHARM.D.
Provider Business Mailing Address
First Line : 110 MOUNTAIN BLVD EXT
Second Line :
City : WARREN
State : NJ
Zip : 07059-5633
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 MOUNTAIN BLVD EXT
Second Line :
City : WARREN
State : NJ
Zip : 07059-5633
Country : US
Telephone Number : 732-907-6745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2012
Last Update Date : 08/17/2012

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Directions to “ KAMILLA KOGAN PHARM.D.” Practice Location

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