Provider Demographics
NPI:1487196549
Name:KOYFMAN, LUZ VIVIANA
Entity Type:Individual
Prefix:MS
First Name:LUZ
Middle Name:VIVIANA
Last Name:KOYFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 SCHENCK AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3930
Mailing Address - Country:US
Mailing Address - Phone:917-963-0467
Mailing Address - Fax:347-836-8305
Practice Address - Street 1:3612 36TH AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-1334
Practice Address - Country:US
Practice Address - Phone:718-819-8623
Practice Address - Fax:347-836-8305
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator