Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 244144 | NY |
NPI | 1114067501 |
---|---|
Provider Name | Dr. Sergey Koyfman |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Middletown, NY 10941-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 03/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
97F18EA041 | MEDICARE INDIVIDUAL (01) | NY |
H96221 | (02) | MI |
WEA041 | MEDICARE - GROUP NUMBER (01) | NY |