Provider Demographics
NPI:1902807902
Name:COGEN, FREDERICK CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:CHARLES
Last Name:COGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8095
Mailing Address - Country:US
Mailing Address - Phone:215-947-6690
Mailing Address - Fax:215-947-4726
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8095
Practice Address - Country:US
Practice Address - Phone:215-947-6690
Practice Address - Fax:215-947-4726
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05175900207K00000X
PAMD014113E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086612ALCMedicare PIN
PA067154JSWMedicare PIN
NJB34787Medicare UPIN