# HERALD SQUARE MEDICAL WELLNESS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952961179
- **Authorized official:** DR. RICHARD KOFFLER MD (PRESIDENT)
- **Authorized official phone:** (646) 454-8264

## Contact information

- **Practice address:** 45 W 34TH ST RM 1201, NEW YORK, NY 10001-3124
- **Practice address phone:** (646) 454-8264
- **Practice address fax:** (855) 312-6352
- **Mailing address:** 45 W 34TH ST RM 1201, NEW YORK, NY 10001-3124
- **Mailing address phone:** (646) 454-8264
- **Mailing address fax:** (855) 312-6352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2019
- **Last updated:** 06/19/2019