Organization
MIKHAIL KOGAN PHYSICIAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL KOGAN (PRESIDENT/ OWNER)
(212) 255-2333
Entity
Organization
Contact information
Practice address
9785 QUEENS BLVD, REGO PARK, NY 11374-3319
(718) 261-9100
Mailing address
65 FIR DR, ROSLYN, NY 11576-2405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
204869
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3C6656
HEALTHNET
NY
01
—
5399428
GHI
NY
01
—
P2124210
OXFORD
NY
Enumeration date
09/30/2006
Last updated
07/17/2008
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