Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 309036 | NY |
N | 363LW0102X | Nurse Practitioner - Women's Health | 421380 | NY |
NPI | 1033676366 |
---|---|
Provider Name | Judith R Coffey |
First Address | New York, NY 10016-5337 |
Second Address | New York, NY 10016-5337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2019 |
Last Update Date | 22/02/2019 |