Provider Demographics
NPI:1447790811
Name:KOGAN, ARIEL RACHEL (RN)
Entity Type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:RACHEL
Last Name:KOGAN
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 1:2775 E 12TH ST
Mailing Address - Street 2:APT 316
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2775 E 12TH ST
Practice Address - Street 2:APT 316
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4655
Practice Address - Country:US
Practice Address - Phone:718-483-4015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY723860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse