Provider Demographics
NPI:1154723179
Name:KOYFMAN, SAMUELA
Entity type:Individual
Prefix:
First Name:SAMUELA
Middle Name:
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 1:1173 N PRICE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2301
Mailing Address - Country:US
Mailing Address - Phone:314-569-1899
Mailing Address - Fax:314-569-9026
Practice Address - Street 1:1173 N PRICE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-2301
Practice Address - Country:US
Practice Address - Phone:314-569-1899
Practice Address - Fax:314-569-9026
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker