Provider Demographics
NPI:1265525661
Name:COFRESI, NORMA I (PHD)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:I
Last Name:COFRESI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 FORDHAM HILL OVAL
Mailing Address - Street 2:APT 5E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4813
Mailing Address - Country:US
Mailing Address - Phone:917-828-1497
Mailing Address - Fax:
Practice Address - Street 1:251 FORT WASHINGTON AVE
Practice Address - Street 2:APT 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1228
Practice Address - Country:US
Practice Address - Phone:917-828-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017096-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical