Healthcare Provider Details

I. General information

NPI: 1346209566
Provider Name (Legal Business Name): KAUFFMAN FOOT AND ANKLE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 LAUREL RD E
STRATFORD NJ
08084-1364
US

IV. Provider business mailing address

13 LAUREL RD E
STRATFORD NJ
08084-1364
US

V. Phone/Fax

Practice location:
  • Phone: 856-783-3338
  • Fax: 856-783-6223
Mailing address:
  • Phone: 856-783-3338
  • Fax: 856-783-6223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00152100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number25MD00262600
License Number StateNJ

VIII. Authorized Official

Name: DR. LAWRENCE D KAUFFMAN
Title or Position: MANAGING MEMBER
Credential: DPM
Phone: 856-783-3338