Hogan-Moulton, Amy Elizabeth

Hogan-Moulton, Amy Elizabeth is an individual health care provider with primary practice located at 2 Broad Street Plz Broad Street Medical Group, Glens Falls NY 12801-4363. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Nephrology is her primary health care specialty. Hogan-Moulton, Amy Elizabeth can be contacted via phone (518) 926-1770.

Contact Information

Primary practice address
2 Broad Street Plz Broad Street Medical Group Glens Falls NY 12801-4363
Phone: (518) 926-1770
Fax: (518) 926-1799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 210381 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 210381 New York

Profile Details

NPI number 1730177825
LBN Legal business name Hogan-Moulton, Amy Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jun 5th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730177825 NPPES
New York Other 390006064 RR MEDICARE
New York MEDICAID 01824359 RR MEDICARE

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