Individual
DR. ELLEN KOFFLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-6902
(718) 226-6844
Mailing address
1 EDGEWATER ST, SUITE 723, STATEN ISLAND, NY 10305-4900
(718) 226-1008
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
149195
NY
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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