Provider Demographics
NPI:1497176218
Name:HOGAN, LAUREN (RDN, CDN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4608
Mailing Address - Country:US
Mailing Address - Phone:201-436-0033
Mailing Address - Fax:201-436-0079
Practice Address - Street 1:19 E 27TH ST
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4608
Practice Address - Country:US
Practice Address - Phone:201-436-0033
Practice Address - Fax:201-436-0079
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1065450133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic