Provider Demographics
NPI:1922083989
Name:HOGAN, HARRIETTE FESER (MD)
Entity Type:Individual
Prefix:MRS
First Name:HARRIETTE
Middle Name:FESER
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1603
Mailing Address - Country:US
Mailing Address - Phone:716-884-0230
Mailing Address - Fax:716-884-2415
Practice Address - Street 1:1131 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1603
Practice Address - Country:US
Practice Address - Phone:716-884-0230
Practice Address - Fax:716-884-2415
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1916212080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005117731OtherBLUE CROSS/CB
NY01398705Medicaid
NY1205536OtherINDEPENDENT HEALTH ASSOC
NY00010078101OtherUNIVERA