Provider Demographics
NPI:1659485431
Name:KOFINAS, GEORGE D (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:D
Last Name:KOFINAS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BROADWAY
Mailing Address - Street 2:FLOOR 14
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006
Mailing Address - Country:US
Mailing Address - Phone:212-348-4000
Mailing Address - Fax:212-348-4001
Practice Address - Street 1:65 BROADWAY
Practice Address - Street 2:FLOOR 14
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006
Practice Address - Country:US
Practice Address - Phone:212-348-4000
Practice Address - Fax:212-348-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155112207VE0102X
NY60155112207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7100016OtherGHI
NYP476298OtherOXFORD
NY0489890OtherAETNA
NYNZ0631OtherHEALTHNET
NY72D181OtherBCBS
NY7100016OtherGHI