Olivia Leigh Pogan | Staten Island, NY • PECOS Search

Olivia Leigh Pogan

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

40 Merrill Ave, Staten Island, NY 10314-3312

(718) 370-7529 (718) 682-1330

PECOS Enrollment

Based on the most recent information from CMS, provider Olivia Leigh Pogan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1801105648
Provider Type
Individual
Full Name
Pogan, Olivia Leigh
Title
Mrs.
Credential
M.S.CCC-SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/28/2010
Last Updated
9/28/2010

Contact Information

Practice Location

40 Merrill Ave, Staten Island, NY 10314-3312

Unlisted Fax

Mailing Location

357 Maine Ave, Staten Island, NY 10314-2210

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 015405-1 New York