Provider Demographics
NPI:1114164464
Name:KAUFMANN, BARBIE (CPT, CN)
Entity Type:Individual
Prefix:
First Name:BARBIE
Middle Name:
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:CPT, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 COURTLAND DR
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6336
Mailing Address - Country:US
Mailing Address - Phone:631-873-8175
Mailing Address - Fax:631-328-1911
Practice Address - Street 1:1060 COURTLAND DR
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6336
Practice Address - Country:US
Practice Address - Phone:631-873-8175
Practice Address - Fax:631-328-1911
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133NN1002X133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education