Healthcare Provider Details

I. General information

NPI: 1073878526
Provider Name (Legal Business Name): VIRGINIA M KAUFMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOLLAND AVE
ALBANY NY
12208-3410
US

IV. Provider business mailing address

205 KENWOOD AVENUE APT A
DELMAR NY
12054
US

V. Phone/Fax

Practice location:
  • Phone: 518-626-5000
  • Fax:
Mailing address:
  • Phone: 518-626-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015655
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: