Provider Demographics
NPI:1326294877
Name:DAVID B. KAUFMAN, MD PC
Entity Type:Organization
Organization Name:DAVID B. KAUFMAN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-548-1590
Mailing Address - Street 1:2600 NETHERLAND AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4801
Mailing Address - Country:US
Mailing Address - Phone:718-548-1590
Mailing Address - Fax:718-601-6206
Practice Address - Street 1:2600 NETHERLAND AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4801
Practice Address - Country:US
Practice Address - Phone:718-548-1590
Practice Address - Fax:718-601-6206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142146 1207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0007122OtherGHI
NY3C5070OtherHEALTHNET
NYP840679OtherOXFORD
NY72D071Medicare PIN
NY3C5070OtherHEALTHNET