Doctor Name: | DR. KOVI BESSOFF |
NPI Number: | 1144616806 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 300 Pasteur Dr Rm H3591 Stanford, CA - 943052200 |
Business Phone Number: | 6507252181 |
Business Fax Number: | 6507249806 |
Mailing Address: | 60 Winooski Falls Way, Unit 1101 WINOOSKI |
State: | VT |
Postal Code: | 054042248 |
Phone Number: | 3038597453 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2015 |
NPI Last Update Date: | 04/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |