Provider Demographics
NPI:1972554202
Name:KAUFMAN, LISA J (PT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:23825 COMMERCE PARK
Mailing Address - Street 2:STE B
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5837
Mailing Address - Country:US
Mailing Address - Phone:216-292-6363
Mailing Address - Fax:216-292-6306
Practice Address - Street 1:3755 ORANGE PL
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4455
Practice Address - Country:US
Practice Address - Phone:216-825-0203
Practice Address - Fax:216-825-0205
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist