Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 22759 | NC |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2401221 | NY |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 22759 | NC |
NPI | 1518941996 |
---|---|
Provider Name | Dr. Jamie Koufman |
First Address | New York, NY 10019 |
Second Address | New York, NY 10019-3211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 02/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C84987 | (02) |