Provider Demographics
NPI:1689780785
Name:VOGEL, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:VOGEL
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 1:111 E 88TH ST
Mailing Address - Street 2:APT. 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1111
Mailing Address - Country:US
Mailing Address - Phone:212-369-4250
Mailing Address - Fax:212-699-0009
Practice Address - Street 1:111 E 88TH ST
Practice Address - Street 2:APT. 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1111
Practice Address - Country:US
Practice Address - Phone:212-369-4250
Practice Address - Fax:212-699-0009
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092394207R00000X, 207RX0202X, 246QH0000X
NY09234207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No246QH0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00148967Medicaid
NYB87450Medicare UPIN
NYA400023174Medicare PIN
NYB87450Medicare UPIN
UMS91124Medicare ID - Type Unspecified