Provider Demographics
NPI:1609293505
Name:KAUFMAN CHIROPRACTIC
Entity Type:Organization
Organization Name:KAUFMAN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-372-0080
Mailing Address - Street 1:412 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-2405
Mailing Address - Country:US
Mailing Address - Phone:201-372-0080
Mailing Address - Fax:201-372-0025
Practice Address - Street 1:412 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-2405
Practice Address - Country:US
Practice Address - Phone:201-372-0080
Practice Address - Fax:201-372-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00636300111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ104247Medicare UPIN