Provider Demographics
NPI:1457699704
Name:DJH KAUFFMANN MD PC
Entity Type:Organization
Organization Name:DJH KAUFFMANN MD PC
Other - Org Name:DAN H.-KAUFFMANN JOKL, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND SOLE PROPIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:H - K
Authorized Official - Last Name:JOKL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-337-3524
Mailing Address - Street 1:1 STONE PL
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3426
Mailing Address - Country:US
Mailing Address - Phone:914-337-3524
Mailing Address - Fax:
Practice Address - Street 1:1 STONE PL
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3426
Practice Address - Country:US
Practice Address - Phone:914-337-3524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114324261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1144248964OtherNPI-1
NY570981OtherMEDICARE ID-TYPE UNSPECIFIED
NY00209238Medicaid
NY570981OtherMEDICARE ID-TYPE UNSPECIFIED