Provider Demographics
NPI:1780629014
Name:KOFSKY, STEVEN MARK (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MARK
Last Name:KOFSKY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PLZ
Mailing Address - Street 2:HS204
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5301
Mailing Address - Country:US
Mailing Address - Phone:718-780-4522
Mailing Address - Fax:718-780-4524
Practice Address - Street 1:1 UNIVERSITY PLZ
Practice Address - Street 2:HS204
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5301
Practice Address - Country:US
Practice Address - Phone:718-780-4531
Practice Address - Fax:718-780-4524
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024663-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN46882OtherHEALTH NET
NY1779725OtherUNITED HEALTHCARE
NYN46882OtherHEALTH NET