Custom Longevity P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CUSTOM LONGEVITY P.A.

Practice address

4005 Gulf Shore Blvd N Apt 402
Naples, FL 34103-3433

Phone

(917) 292-8074

NPI assigned

Oct 24, 2018

Last updated

Oct 24, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Svetlana Kogan, MDNPI 1023054707

Title

Owner

Phone

(917) 292-8074

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Svetlana Kogan, M.D.

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1023054707
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1306312731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 GULF SHORE BLVD N APT 402",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033433",
            "telephone_number": "917-292-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 GULF SHORE BLVD N APT 402",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033433",
            "telephone_number": "917-292-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM LONGEVITY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-292-8074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Jean Curran, RD, LD/N
• Alecia Nicole Currie
• Jaci Currie
• Sylvia Currie, LCSW
• Randall S. Curro
• Gabriella Maria Cutrali, DO
• Larry Leonard Cuttone, M.D.
• CV Care Group, LLC
• CWBC, Inc
• Rachel Czahor

• Internal Medicine Physician in Naples, FL
• Providers in Naples, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.