Provider Demographics
NPI:1760510077
Name:KOGAN, SOFIYA (RPH)
Entity Type:Individual
Prefix:
First Name:SOFIYA
Middle Name:
Last Name:KOGAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:SOFIYA
Other - Middle Name:
Other - Last Name:KOGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7404
Mailing Address - Country:US
Mailing Address - Phone:212-423-6609
Mailing Address - Fax:
Practice Address - Street 1:1901 FIRST AVE
Practice Address - Street 2:METROPOLITAN HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist