Provider Demographics
NPI:1821308545
Name:HOGAN, SARAH J (RN, LPN)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:J
Last Name:HOGAN
Suffix:
Gender:F
Credentials:RN, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HERB HILL RD
Mailing Address - Street 2:PH37
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4413
Mailing Address - Country:US
Mailing Address - Phone:631-740-1736
Mailing Address - Fax:
Practice Address - Street 1:300 HERB HILL RD
Practice Address - Street 2:PH37
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4413
Practice Address - Country:US
Practice Address - Phone:631-740-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267950-1164W00000X
NY766341-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse