Provider Demographics
NPI:1003604091
Name:KOGAN, TANYA
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:KOGAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 OSWALD PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3615
Mailing Address - Country:US
Mailing Address - Phone:646-702-3952
Mailing Address - Fax:646-702-3952
Practice Address - Street 1:46 OSWALD PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3615
Practice Address - Country:US
Practice Address - Phone:646-243-8649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula