Provider Demographics
NPI:1831234574
Name:KAUFMAN, THERESA J (OD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:J
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 FARMINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2311
Mailing Address - Country:US
Mailing Address - Phone:717-808-7669
Mailing Address - Fax:
Practice Address - Street 1:800 PARK CITY CTR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2720
Practice Address - Country:US
Practice Address - Phone:717-299-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE007631P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist