Provider Demographics
NPI:1346280591
Name:COGAN, ANDREW M (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:COGAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:979 N BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1044
Practice Address - Country:US
Practice Address - Phone:856-629-5151
Practice Address - Fax:856-629-0281
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-04-04
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06500100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG96628Medicare UPIN
028351SK3Medicare PIN
077356Medicare PIN