Provider Demographics
NPI:1992887277
Name:KAUFMAN, IRIS ANN (APRN, BC, FNP)
Entity type:Individual
Prefix:MS
First Name:IRIS
Middle Name:ANN
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:APRN, BC, FNP
Other - Prefix:MS
Other - First Name:IRIS
Other - Middle Name:ANN
Other - Last Name:HOROWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC, FNP
Mailing Address - Street 1:75-42 255 STREET
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1839
Mailing Address - Country:US
Mailing Address - Phone:718-413-5879
Mailing Address - Fax:
Practice Address - Street 1:450 C LAKEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042-2810
Practice Address - Country:US
Practice Address - Phone:516-734-8070
Practice Address - Fax:516-734-8075
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily