Provider Demographics
NPI:1902452691
Name:COFFIN, LINDSEY (MS ED)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:COFFIN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DOROTHY ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-1723
Mailing Address - Country:US
Mailing Address - Phone:631-793-8973
Mailing Address - Fax:
Practice Address - Street 1:52 OLD POST RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3742
Practice Address - Country:US
Practice Address - Phone:631-793-8973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-18
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist