Provider Demographics
NPI:1679658744
Name:KAUFMAN, GREG (MD)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 25
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-0404
Mailing Address - Fax:516-222-0615
Practice Address - Street 1:901 STEWART AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4893
Practice Address - Country:US
Practice Address - Phone:516-222-0404
Practice Address - Fax:516-222-2268
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY214035207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52C611Medicare ID - Type Unspecified
NYH07538Medicare UPIN