Michele Kofman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

68 017879 Issued in NY

Practice address

210 W 70TH St
Suite 1
New York, NY 10023-4304

Phone

(917) 405-3991

NPI assigned

Feb 9, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 19, 2024 through Jun 19, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michele D Kofman Psychologist PC

  • Adult Mental Health Clinic/Center
  • New York, NY
  • NPI 1497148373
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1992944383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 70TH ST",
            "address_2": "SUITE 001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234304",
            "telephone_number": "917-405-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 70TH ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234304",
            "telephone_number": "917-405-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFMAN",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68 017879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Carl Koffler, M.D.
• Antonia F Kofinas, M.D.
• George D Kofinas, M.D.
• Jason D Kofinas, M.D.
• Kalli Kofinas
• Anna Kogan
• Avrimin Kogan, M.D.
• Howard Joel Kogan, LCSW
• Jennie Rose Kogan, LMSW
• Livia A. Kogan, PA

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.