Individual
IRINA KOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
464 HILLSIDE AVE, NEEDHAM, MA 02494-1227
(781) 449-5170
Mailing address
464 HILLSIDE AVE, NEEDHAM, MA 02494-1227
(781) 449-5170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
203536
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9727540
—
MA
Enumeration date
08/28/2006
Last updated
03/29/2011
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