Provider Demographics
NPI:1346209566
Name:KAUFFMAN FOOT AND ANKLE SPECIALISTS
Entity Type:Organization
Organization Name:KAUFFMAN FOOT AND ANKLE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-783-3338
Mailing Address - Street 1:13 LAUREL RD E
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1364
Mailing Address - Country:US
Mailing Address - Phone:856-783-3338
Mailing Address - Fax:856-783-6223
Practice Address - Street 1:13 LAUREL RD E
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1364
Practice Address - Country:US
Practice Address - Phone:856-783-3338
Practice Address - Fax:856-783-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00152100213E00000X
NJ25MD00262600332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2930767OtherAETNA
NJ2930767OtherAETNA
NJ2930767OtherAETNA
NJ4792550001Medicare NSC
NJ479255Medicare PIN
NJ046609Medicare ID - Type Unspecified