Provider Demographics
NPI:1831130038
Name:KAUFMAN, STEPHEN E SR
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:KAUFMAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 RYDAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1711
Mailing Address - Country:US
Mailing Address - Phone:267-620-1100
Mailing Address - Fax:215-572-1273
Practice Address - Street 1:1095 RYDAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1711
Practice Address - Country:US
Practice Address - Phone:267-620-1100
Practice Address - Fax:215-572-1273
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019834E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14617OtherHEALTH PARTNERS
PA5631393OtherAETNA
PW000754206005Medicaid
PA1086169OtherKEYSTONE MERCY
PA231937219OtherDEVON
PA100006775OtherPALMETTO GBA
PA231937219OtherFIRST HEALTH
PA058979OtherHIGHMARK BULE SHIELD
PA000058979OtherPERSONAL CHOICE
PW058979OtherAMERIHEALTH
PA2993074004OtherCIGNA
PA231937219OtherTRICARE
PA0046033000OtherKEYSTONE EAST
PA231937219OtherMULTIPLAN
PAP393422OtherOXFORD
PA231937219OtherDEVON