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NPI Code Detail

MEDICARE: MISS OLIVIA ISABELLA COFFIN BA, AS

MEDICARE: MISS OLIVIA ISABELLA COFFIN BA, AS
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
1171M00000XCase Manager/Care CoordinatorNY

General Provider Information

NPI Number : 1881544492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS OLIVIA ISABELLA COFFIN BA, AS
Provider Business Mailing Address
First Line : 32 WOODWARD AVE
Second Line :
City : GLOVERSVILLE
State : NY
Zip : 12078-4141
Country : US
Telephone Number : 518-725-4310
Fax Number :
Provider Business Practice Location Address
First Line : 11-21 BROADWAY ST
Second Line :
City : GLOVERSVILLE
State : NY
Zip : 12078-3964
Country : US
Telephone Number : 518-725-4310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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