Provider Demographics
NPI:1801108436
Name:KAUFMANN, JOHANNA MARIE (DPT)
Entity type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:MARIE
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:JOHANNA
Other - Middle Name:MARIE
Other - Last Name:RAYMOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 693
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0693
Mailing Address - Country:US
Mailing Address - Phone:585-582-6223
Mailing Address - Fax:585-582-1128
Practice Address - Street 1:4 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1445
Practice Address - Country:US
Practice Address - Phone:585-243-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032799-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist