Provider Demographics
NPI:1811346166
Name:KOYFMAN, VLADISLAV (OD)
Entity type:Individual
Prefix:DR
First Name:VLADISLAV
Middle Name:
Last Name:KOYFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DR. EYEFIT LLC
Mailing Address - Street 2:25 CHURCH HILL RD.
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470
Mailing Address - Country:US
Mailing Address - Phone:203-426-5586
Mailing Address - Fax:203-426-3366
Practice Address - Street 1:DR. EYEFIT LLC
Practice Address - Street 2:25 CHURCH RD.
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470
Practice Address - Country:US
Practice Address - Phone:203-426-5586
Practice Address - Fax:203-426-3355
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9023TG152W00000X
NY56 008429152W00000X, 152WC0802X, 152WP0200X, 152WV0400X
CT3.003243152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy