Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 207111 | NY |
NPI | 1144374380 |
---|---|
Provider Name | Mrs. Faina Kogan |
First Address | Roslyn, NY 11576-2405 |
Second Address | Brooklyn, NY 11223-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 05/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01793035 | (05) | NY |
G62371 | (02) | NY |