Provider Demographics
NPI:1801081609
Name:KUFTINEC, DANEIL COPERTINO (MD)
Entity type:Individual
Prefix:
First Name:DANEIL
Middle Name:COPERTINO
Last Name:KUFTINEC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC, INC.
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8000
Mailing Address - Fax:
Practice Address - Street 1:131 ORNAC STE 740
Practice Address - Street 2:LAHEY CLINIC UROLOGICAL INSTIT
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4162
Practice Address - Country:US
Practice Address - Phone:978-369-5551
Practice Address - Fax:978-369-1580
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2011-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA242407208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084414AMedicaid