Provider Demographics
NPI:1740642792
Name:KAUFMAN, MICHELLE (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 MAMARONECK AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2433
Mailing Address - Country:US
Mailing Address - Phone:914-472-1000
Mailing Address - Fax:914-472-1008
Practice Address - Street 1:440 MAMARONECK AVE STE 502
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2433
Practice Address - Country:US
Practice Address - Phone:914-472-1000
Practice Address - Fax:914-472-1008
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY007200213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program