Provider Demographics
NPI:1104914100
Name:KAUFMAN, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W 58TH ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1827
Mailing Address - Country:US
Mailing Address - Phone:212-969-9540
Mailing Address - Fax:212-969-9547
Practice Address - Street 1:90 MAIDEN LN
Practice Address - Street 2:FL 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4831
Practice Address - Country:US
Practice Address - Phone:646-290-9560
Practice Address - Fax:212-532-4362
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155320174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14E291Medicare PIN