Mogan, Glen Raymond
Mogan, Glen Raymond is an sole proprietor health care provider with primary practice located at 200 S Orange Ave Suite 128, Livingston NJ 07039-5817. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mogan, Glen Raymond can be contacted via phone (973) 322-7755.Contact Information
Primary practice address
200 S Orange Ave Suite 128
Livingston NJ 07039-5817
Phone: (973) 322-7755
Fax: (973) 322-7764
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 25MA037333 | New Jersey |
Profile Details
| NPI number | 1326015124 |
|---|---|
| LBN Legal business name | Mogan, Glen Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Apr 5th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326015124 | NPPES |
| New Jersey | MEDICAID | 0355607 |
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