Provider Demographics
NPI:1134140858
Name:KAUFMAN, TOBY BREITSTEIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:BREITSTEIN
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 GROVE TER
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2429
Mailing Address - Country:US
Mailing Address - Phone:973-762-2415
Mailing Address - Fax:
Practice Address - Street 1:530 GROVE TER
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2429
Practice Address - Country:US
Practice Address - Phone:973-762-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ7312103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist