Provider Demographics
NPI:1578515011
Name:KAUFMAN, JEFFREY I (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:I
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HWY 35 NORTH
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2103
Mailing Address - Country:US
Mailing Address - Phone:732-389-6512
Mailing Address - Fax:732-389-0585
Practice Address - Street 1:1147 HWY 35
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2605
Practice Address - Country:US
Practice Address - Phone:732-671-7300
Practice Address - Fax:732-671-1605
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00281600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ529559Medicare PIN
NJU51383Medicare UPIN