Provider Demographics
NPI:1881667418
Name:KOFSKY, IRWIN MARTIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:MARTIN
Last Name:KOFSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 EMERSON CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2819
Mailing Address - Country:US
Mailing Address - Phone:914-245-6789
Mailing Address - Fax:
Practice Address - Street 1:120 EMERSON CT
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2819
Practice Address - Country:US
Practice Address - Phone:914-245-6789
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2074213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00405110Medicaid
T71167Medicare UPIN
NYP16541Medicare ID - Type Unspecified