Healthcare Provider Details

I. General information

NPI: 1437150513
Provider Name (Legal Business Name): ALAN KAUFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 E TREMONT AVE
BRONX NY
10465-2030
US

IV. Provider business mailing address

3626 E TREMONT AVE
BRONX NY
10465-2030
US

V. Phone/Fax

Practice location:
  • Phone: 718-597-9000
  • Fax: 718-597-9001
Mailing address:
  • Phone: 718-597-9000
  • Fax: 718-597-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number170711
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: