Individual
MR. JAY STUART KOGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3300 CONCORD PIKE STE 4, WILMINGTON, DE 19803-5038
(302) 753-2700
(302) 478-1975
Mailing address
2542 BERWYN RD, WILMINGTON, DE 19810-3500
(302) 479-0301
(302) 479-9004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0000423
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57287
AETNA
DE
Enumeration date
07/14/2006
Last updated
04/29/2025
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