Provider Demographics
NPI:1295177491
Name:HOGAN, RHONDA B (LAC)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:B
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 EASTON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1855
Mailing Address - Country:US
Mailing Address - Phone:732-227-9991
Mailing Address - Fax:
Practice Address - Street 1:710 EASTON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1855
Practice Address - Country:US
Practice Address - Phone:732-227-9991
Practice Address - Fax:732-227-9992
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ000165000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist