MEDICARE: DR. NATALYA KOFMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	220659	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609950161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALYA KOFMAN D.O.

Provider Business Mailing Address
First Line	:	4379 BEDFORD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4928
Country	:	US
Telephone Number	:	718-934-1353
Fax Number	:	718-376-0400

Provider Business Practice Location Address
First Line	:	2748 OCEAN AVE APT 6
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4735
Country	:	US
Telephone Number	:	718-376-1325
Fax Number	:	718-376-0400

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	11/18/2025

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