Provider Demographics
NPI:1417925603
Name:KAUFFMAN, PHILIP I (DPM)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:I
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD-002626213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81668Medicare UPIN
NJ045037Medicare PIN