Healthcare Provider Details

I. General information

NPI: 1700297041
Provider Name (Legal Business Name): CHAYA KAUFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SULLIVAN PLACE APT 4M
BROOKLYN NY
11225
US

IV. Provider business mailing address

301 SULLIVAN PL APT 4M
BROOKLYN NY
11225
US

V. Phone/Fax

Practice location:
  • Phone: 201-747-0735
  • Fax:
Mailing address:
  • Phone: 201-747-0735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number312175
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: