Healthcare Provider Details

I. General information

NPI: 1962404178
Provider Name (Legal Business Name): E.H. KAUFMAN ENTERPRIZES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 CHAPEL ST
NEW HAVEN CT
06511-6992
US

IV. Provider business mailing address

627 CHAPEL ST
NEW HAVEN CT
06511-6919
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-2396
  • Fax:
Mailing address:
  • Phone: 203-777-2396
  • Fax: 203-777-4617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1119597
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1119597
License Number StateCT

VIII. Authorized Official

Name: MR. EDWARD NICHOLAS KAUFMAN
Title or Position: CEO
Credential:
Phone: 203-777-2396