Healthcare Provider Details

I. General information

NPI: 1881131456
Provider Name (Legal Business Name): MR. DONALD COFIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 TELLER AVE
BRONX NY
10456-1002
US

IV. Provider business mailing address

1401 TELLER AVE
BRONX NY
10456-1002
US

V. Phone/Fax

Practice location:
  • Phone: 347-739-8770
  • Fax:
Mailing address:
  • Phone: 347-739-8770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100229
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: