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General NPI Number Information
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NPI Number | 1851594147
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Entity Type | Organization
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Legal Business Name | DR. SIMON KOYFMAN, PHYSICIAN, P.L.L.C.
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 170 AVENUE S
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City | BROOKLYN
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State | NY
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Zip | 11223-2633
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Country | US
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Telephone | 718-382-8282
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Fax | 718-946-7964
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Provider Business Mailing Address
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Address Line | 170 AVENUE S
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City | BROOKLYN
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State | NY
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Zip | 11223-2633
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Country | US
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Telephone | 718-382-8282
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Fax | 718-946-7964
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SIMON KOYFMAN
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Credential | M.D., D.O.
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Telephone | 718-382-8282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 204787
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License Number State | NY
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