Basic Information
| Provider Information | |||||||||
| NPI: | 1942409396 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOGAN | ||||||||
| FirstName: | MAUREEN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 HICKSVILLE RD | ||||||||
| Address2: | STE 104 | ||||||||
| City: | SEAFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117831300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167980141 | ||||||||
| FaxNumber: | 5167980694 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 HICKSVILLE RD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | SEAFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117831300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167980141 | ||||||||
| FaxNumber: | 5167980694 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2007 | ||||||||
| LastUpdateDate: | 06/09/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | F340277-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.