Individual
MICHELLE J KOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8787 FRANCIS LEWIS BLVD, QUEENS VILLAGE, NY 11427-2867
(718) 465-4999
(718) 217-6101
Mailing address
8787 FRANCIS LEWIS BLVD, QUEENS VILLAGE, NY 11427-2867
(718) 465-4999
(718) 217-6101
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01799119
—
NY
Enumeration date
03/21/2007
Last updated
07/08/2007
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