Healthcare Provider Details

I. General information

NPI: 1043807704
Provider Name (Legal Business Name): DR. ELIZABETH FRANCES KOFSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 W NC HIGHWAY 54
DURHAM NC
27707-5548
US

IV. Provider business mailing address

510 E TRINITY AVE
DURHAM NC
27701-1951
US

V. Phone/Fax

Practice location:
  • Phone: 919-403-8059
  • Fax:
Mailing address:
  • Phone: 845-242-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29995
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: