Individual
KOFFI KODOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE
Contact information
Practice address
21223 HOLLIS AVE, QUEENS VILLAGE, NY 11429
(202) 294-7955
Mailing address
21223 HOLLIS AVE, QUEENS VILLAGE, NY 11429
(202) 294-7955
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
321675
NY
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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