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General NPI Number Information
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NPI Number | 1083746929
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Entity Type | Individual
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Provider Name | PAULETTE KOUFFMAN PHD
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 220 E 23RD ST SUITE 400
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City | NEW YORK
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State | NY
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Zip | 10010-4606
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Country | US
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Telephone | 718-593-7717
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Fax | 212-725-1790
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Provider Business Mailing Address
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Address Line | 50 BRIGHTON FIRST RD., APT. 16D
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-593-7717
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Fax | 212-725-1790
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0153141
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License Number State | NY
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