Provider Demographics
NPI:1821252966
Name:KAUFMAN, DANIELLE R (PA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 WASHINGTON RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3194
Mailing Address - Country:US
Mailing Address - Phone:724-880-7860
Mailing Address - Fax:
Practice Address - Street 1:3311 WASHINGTON RD STE 302
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3194
Practice Address - Country:US
Practice Address - Phone:724-880-7860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01462363AM0700X
PAMA015427363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical