Organization
KOGAN PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TODD KOGAN CP, BOCO (PRESIDENT)
(267) 614-1538
Entity
Organization
Contact information
Practice address
1547 BITTERSWEET CIR, JAMISON, PA 18929-1429
(267) 614-1538
(267) 897-9055
Mailing address
1547 BITTERSWEET CIR, JAMISON, PA 18929-1429
(267) 614-1538
(267) 897-9055
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002035000
AMERIHEALTH HEALTH PLANS
PA
01
—
0002035000
KEYSTONE 65
—
05
—
1012223920001
—
PA
01
—
1675249
HIGHMARK BLUE SHIELD
—
01
—
3753541
AETNA
PA
Enumeration date
01/08/2008
Last updated
01/08/2008
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