Provider Demographics
NPI:1831452705
Name:KAUFMAN, REBECCA SUSAN (MSED)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:SUSAN
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 GANSEVOORT BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4026
Mailing Address - Country:US
Mailing Address - Phone:718-761-7944
Mailing Address - Fax:
Practice Address - Street 1:92 GANSEVOORT BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4026
Practice Address - Country:US
Practice Address - Phone:718-761-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist