Provider Demographics
NPI:1245277441
Name:KAUFMAN, SETH A (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:A
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 KIMBALL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01506-1638
Mailing Address - Country:US
Mailing Address - Phone:617-636-6161
Mailing Address - Fax:
Practice Address - Street 1:750 WASHINGTON STREET, BOX 359
Practice Address - Street 2:NEW ENGLAND MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264352085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000140134OtherBOSTON MEDICAL CENTER THROUGH VALLEY HEALTH PHO
MA93830202OtherNETWORK HEALTH
MAAA452173OtherHARVARD PILGRIM AND TUFTS THROUGH VALLEY HEALTH PHO
MAJ40104OtherBCBS
MAP01444702OtherRR MEDICARE ID #
MA7105716OtherCIGNA
MA1555908OtherCOVENTRY INDIV. ID #
MA1245277441OtherMASS HEALTH
MA93830202OtherNETWORK HEALTH