Provider Demographics
NPI:1164446894
Name:KAUFFMAN, JEFFREY (MSS)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:PA
Mailing Address - Zip Code:19470-0155
Mailing Address - Country:US
Mailing Address - Phone:610-310-0136
Mailing Address - Fax:
Practice Address - Street 1:217 POTTSTWON PIKE
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425
Practice Address - Country:US
Practice Address - Phone:610-310-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-002245-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA070673000OtherIDENTIFICATION NUMBER
PA070673000OtherIDENTIFICATION NUMBER