Healthcare Provider Details

I. General information

NPI: 1568336170
Provider Name (Legal Business Name): EMILY KOFFSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 DOBBIN ST STE 204A
BROOKLYN NY
11222-2803
US

IV. Provider business mailing address

3519 BAYSHORE VILLAS DR
MIAMI FL
33133-3254
US

V. Phone/Fax

Practice location:
  • Phone: 347-255-1747
  • Fax:
Mailing address:
  • Phone: 305-979-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP138825
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberP138825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: