MEDICARE: DR. KAREN KAUFFMANN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	009543-1	NY

General Provider Information

NPI Number	:	1932697414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN KAUFFMANN PH.D.

Provider Business Mailing Address
First Line	:	190 BERKELEY PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3802
Country	:	US
Telephone Number	:	347-200-9272
Fax Number	:	718-638-6799

Provider Business Practice Location Address
First Line	:	190 BERKELEY PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3802
Country	:	US
Telephone Number	:	347-200-9272
Fax Number	:	718-638-6799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	04/30/2018

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