Healthcare Provider Details

I. General information

NPI: 1942547310
Provider Name (Legal Business Name): MEGAN HOPE KOFFSKY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2013
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date: 03/05/2025
Reactivation Date: 03/21/2025

III. Provider practice location address

39 TOTTEN PL
BABYLON NY
11702-2809
US

IV. Provider business mailing address

39 TOTTEN PL
BABYLON NY
11702-2809
US

V. Phone/Fax

Practice location:
  • Phone: 646-639-7813
  • Fax:
Mailing address:
  • Phone: 646-639-7813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF406758-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: