Provider Demographics
NPI:1144371832
Name:HOGAN, STEVEN PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PAUL
Last Name:HOGAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 KATE LN
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3529
Mailing Address - Country:US
Mailing Address - Phone:860-875-3638
Mailing Address - Fax:
Practice Address - Street 1:1213 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1907
Practice Address - Country:US
Practice Address - Phone:860-423-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist