Provider Demographics
NPI:1669643524
Name:HOGAN, ANNEMARIE
Entity Type:Individual
Prefix:MRS
First Name:ANNEMARIE
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:CUTLIFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:158 CONCORD RD
Mailing Address - Street 2:#D19
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-4609
Mailing Address - Country:US
Mailing Address - Phone:781-426-1058
Mailing Address - Fax:
Practice Address - Street 1:158 CONCORD RD
Practice Address - Street 2:#D19
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-4609
Practice Address - Country:US
Practice Address - Phone:781-426-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8167225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant