Individual
GENNADIY KOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2037 UTICA AVE, BROOKLYN, NY 11234-3215
(718) 757-9491
Mailing address
2037 UTICA AVE, BROOKLYN, NY 11234-3215
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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