Provider Demographics
NPI:1376019679
Name:KAUFMAN, TAYLOR (CNIM)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:CNIM
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 1945
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-1945
Mailing Address - Country:US
Mailing Address - Phone:719-888-1007
Mailing Address - Fax:
Practice Address - Street 1:1372 W HOYE PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-2704
Practice Address - Country:US
Practice Address - Phone:303-888-4764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO246ZE0600X
246ZE0600X
CO3901246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO246ZE0600XOtherTAXONOMY