Provider Demographics
NPI:1508090325
Name:KOFF, GEOFFREY LANE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:LANE
Last Name:KOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 KEYSTONE AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1127
Mailing Address - Country:US
Mailing Address - Phone:610-394-9860
Mailing Address - Fax:
Practice Address - Street 1:2100 KEYSTONE AVE STE 309
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1127
Practice Address - Country:US
Practice Address - Phone:610-394-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD448256207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease