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NPI Code Detail

MEDICARE: DR. MARA COFLER -KOLDORFF MD

MEDICARE: DR. MARA COFLER -KOLDORFF MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician262673NY

General Provider Information

NPI Number : 1003196171
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARA COFLER -KOLDORFF MD
Provider Business Mailing Address
First Line : 2915 SUNRISE HWY
Second Line :
City : ISLIP TERRACE
State : NY
Zip : 11752-2716
Country : US
Telephone Number : 631-446-1006
Fax Number : 631-446-1009
Provider Business Practice Location Address
First Line : 2915 SUNRISE HWY
Second Line :
City : ISLIP TERRACE
State : NY
Zip : 11752-2716
Country : US
Telephone Number : 631-446-1006
Fax Number : 631-446-1009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 08/22/2011

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Directions to “ DR. MARA COFLER -KOLDORFF MD” Practice Location

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