Provider Demographics
NPI:1922504349
Name:MATTHEWS, EMILY COFSKY (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:COFSKY
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6722
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:2301 N 29TH ST STE 500
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-3454
Practice Address - Country:US
Practice Address - Phone:215-444-7510
Practice Address - Fax:267-388-4659
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017527363LP2300X
PASP019331363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2017025626OtherBOARD CERTIFICATION