Provider Demographics
NPI:1124201041
Name:KAUFMAN, JEFFREY
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15170 CHIPPENDALE AVE W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-2770
Mailing Address - Country:US
Mailing Address - Phone:651-322-7034
Mailing Address - Fax:651-322-7813
Practice Address - Street 1:15170 CHIPPENDALE AVE W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-2770
Practice Address - Country:US
Practice Address - Phone:651-322-7034
Practice Address - Fax:651-322-7813
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies