Provider Demographics
NPI:1841518123
Name:KAUFMAN, THERESA JANE (DO)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:JANE
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1430
Mailing Address - Country:US
Mailing Address - Phone:215-860-3360
Mailing Address - Fax:215-860-3362
Practice Address - Street 1:777 TOWNSHIP LINE ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5567
Practice Address - Country:US
Practice Address - Phone:215-860-3360
Practice Address - Fax:215-860-3362
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB103314002085R0202X
PAOS0175542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103128792Medicaid