Provider Demographics
NPI:1225140775
Name:KAUFMAN, ERIC D (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CONGRUITY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8472
Mailing Address - Country:US
Mailing Address - Phone:724-668-2388
Mailing Address - Fax:724-668-2388
Practice Address - Street 1:8279 STATE ROUTE 22
Practice Address - Street 2:UNIT 6
Practice Address - City:NEW ALEXANDRIA
Practice Address - State:PA
Practice Address - Zip Code:15670-3155
Practice Address - Country:US
Practice Address - Phone:724-668-2388
Practice Address - Fax:724-668-2388
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA056383Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID