Provider Demographics
NPI:1598916223
Name:KOGAN, LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:KOGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:PATIENT FINANCIAL SERVICES
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-259-7627
Mailing Address - Fax:603-259-7561
Practice Address - Street 1:400 W MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3019
Practice Address - Country:US
Practice Address - Phone:631-321-6400
Practice Address - Fax:631-321-2969
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15962207RG0100X
NJNJ 25MA09015600207RG0100X
NY240404207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology