Provider Demographics
NPI:1558308734
Name:KAUFMAN, JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
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 1:4273 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5710
Mailing Address - Country:US
Mailing Address - Phone:516-579-5800
Mailing Address - Fax:516-579-5974
Practice Address - Street 1:4273 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5710
Practice Address - Country:US
Practice Address - Phone:516-579-5800
Practice Address - Fax:516-579-5974
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197625-22085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02232960Medicaid
NYG94673Medicare UPIN
NY02232960Medicaid
NYJK06200630Medicare PIN
NY620061Medicare PIN