Provider Demographics
NPI:1235575564
Name:COGAR, JANICE HUTTA (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:HUTTA
Last Name:COGAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BROADWAY STE 3
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-1404
Mailing Address - Country:US
Mailing Address - Phone:518-891-4471
Mailing Address - Fax:518-891-7238
Practice Address - Street 1:136 BROADWAY STE 3
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-1404
Practice Address - Country:US
Practice Address - Phone:518-891-4471
Practice Address - Fax:518-891-7238
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241583-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health