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
Fax: (973) 322-7764
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326015124 NPPES
New Jersey MEDICAID 0355607

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