| Doctor Name: | MR. MARK KOFMAN |
| NPI Number: | 1669642328 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT |
| License Number: | |
| Business Practice Address: | 122 Kingston Rd Cheltenham, PA - 190121227 |
| Business Phone Number: | 2672507694 |
| Business Fax Number: | 2157823852 |
| Mailing Address: | 122 Kingston Rd, CHELTENHAM |
| State: | PA |
| Postal Code: | 190121227 |
| Phone Number: | 2672507694 |
| Fax Number: | 2157823852 |
| NPI Enumeration Date: | 03/08/2008 |
| NPI Last Update Date: | 03/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251C2600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Cardiopulmonary |
| Taxonomy Definition: | |