Provider Demographics
NPI:1942547310
Name:KOFFSKY, MEGAN HOPE (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:HOPE
Last Name:KOFFSKY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 TOTTEN PL
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2809
Mailing Address - Country:US
Mailing Address - Phone:646-639-7813
Mailing Address - Fax:
Practice Address - Street 1:39 TOTTEN PL
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2809
Practice Address - Country:US
Practice Address - Phone:646-639-7813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2025-03-22
Deactivation Date:2025-03-05
Deactivation Code:
Reactivation Date:2025-03-21
Provider Licenses
StateLicense IDTaxonomies
NYF406758-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health