Provider Demographics
NPI:1437413325
Name:KOFMAN, RIVKA
Entity Type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:KOFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIVKA
Other - Middle Name:
Other - Last Name:REICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:933 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2053
Mailing Address - Country:US
Mailing Address - Phone:732-363-2212
Mailing Address - Fax:
Practice Address - Street 1:1257 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1928
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist