Provider Demographics
NPI:1285696948
Name:KOGANSKI, VALERI (MD)
Entity type:Individual
Prefix:DR
First Name:VALERI
Middle Name:
Last Name:KOGANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 LANGHORNE NEWTOWN RD STE 402
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1086
Mailing Address - Country:US
Mailing Address - Phone:215-750-7000
Mailing Address - Fax:215-750-9572
Practice Address - Street 1:1717 LANGHORNE NEWTOWN RD STE 402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1086
Practice Address - Country:US
Practice Address - Phone:215-750-7000
Practice Address - Fax:215-750-9572
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4931324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5711491OtherAETNA
PA0160148002OtherAMERICHOICE
PA288591ML2OtherMAMSI
PA0016014800004Medicaid
PA889572OtherHIGHMARK BLUE SHIELD
PA2119889001OtherINDEPENDENCE BLUE CROSS
PA1090692OtherKEYSTONE MERCY
PA110245496OtherRR MEDICARE
PAP2806046OtherOXFORD HEALTH
PA300097966OtherTAX ID
PA064862Medicare ID - Type UnspecifiedMEDICARE
PA110245496OtherRR MEDICARE