Provider Demographics
NPI:1265510259
Name:ALLEN M KAUFMAN MD PLLC
Entity Type:Organization
Organization Name:ALLEN M KAUFMAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-438-6986
Mailing Address - Street 1:1555 3RD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3107
Mailing Address - Country:US
Mailing Address - Phone:917-438-6986
Mailing Address - Fax:212-870-9688
Practice Address - Street 1:1555 3RD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3107
Practice Address - Country:US
Practice Address - Phone:917-438-6986
Practice Address - Fax:212-870-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127413174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01269043Medicaid
NY127413OtherINTERNAL MEDICINE
NY127413OtherNEPHROLOGY
NY127413OtherINTERNAL MEDICINE
NY01269043Medicaid