Individual
ELENA KOGAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1010 NORTHERN BLVD, GREAT NECK, NY 11021-5306
(516) 495-5469
Mailing address
130 SHORE RD, PORT WASHINGTON, NY 11050-2205
(516) 495-5469
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
0491131
NY
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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