Provider Demographics
NPI:1477648897
Name:KAUFMAN, BRUCE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DAVID
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PATRIOTS FARM PLACE
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504
Mailing Address - Country:US
Mailing Address - Phone:914-725-8855
Mailing Address - Fax:914-725-8877
Practice Address - Street 1:5 PATRIOTS FARM PLACE
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504
Practice Address - Country:US
Practice Address - Phone:914-725-8855
Practice Address - Fax:914-725-8877
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147065207L00000X
NJ25MA04313600207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5164907Medicaid
NY00843072.Medicaid
NJ5164907Medicaid
NY00843072.Medicaid
NJ0000003106Medicare ID - Type Unspecified