Provider Demographics
NPI:1295190940
Name:KOFF, RIVKA
Entity Type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:KOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIVKA
Other - Middle Name:
Other - Last Name:WACHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 EDISON CT APT B
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1945
Mailing Address - Country:US
Mailing Address - Phone:845-213-8505
Mailing Address - Fax:
Practice Address - Street 1:386 ROUTE 59
Practice Address - Street 2:SUITE 102
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-368-7927
Practice Address - Fax:845-368-7929
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator