Healthcare Provider Details

I. General information

NPI: 1477552024
Provider Name (Legal Business Name): ROBERT E COIFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2005
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 NORTH HIGH ST
MILLVILLE NJ
08332
US

IV. Provider business mailing address

1122 NORTH HIGH ST
MILLVILLE NJ
08332
US

V. Phone/Fax

Practice location:
  • Phone: 856-825-4100
  • Fax: 856-825-1700
Mailing address:
  • Phone: 856-825-4100
  • Fax: 856-825-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number25MA04309000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberMA43090
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: