Individual
DR. JOSEPH J LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
55 PALMER AVE, BRONXVILLE, NY 10708-3403
(908) 358-9319
Mailing address
800 WESTCHESTER AVE, SUITE N-511, RYE BROOK, NY 10573-1354
(914) 428-5454
(914) 428-5460
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
236696
NY
207L00000X
Anesthesiology Physician
25MB08581500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1078533
AETNA - HMO
NY
01
—
1503S2
EMPIRE BC/BS
NY
01
—
2581116
UNITED HEALTHCARE
NY
01
—
4925799
CIGNA
NY
01
—
4C8142
HEALTH NET
NY
01
—
7173769
AETNA - PPO
NY
01
—
P3631260
OXFORD HEALTH PLAN
NY
01
—
PENDING 1ST CLAIM
RAILROAD MEDICARE
NY
01
—
TIN
HORIZION HEALTHCARE
—
Enumeration date
08/14/2006
Last updated
05/16/2013
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