Healthcare Provider Details

I. General information

NPI: 1215135678
Provider Name (Legal Business Name): MIRIAM KAUFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 48TH ST.
BROOKLYN NY
11219
US

IV. Provider business mailing address

1410 48TH ST.
BROOKLYN NY
11219
US

V. Phone/Fax

Practice location:
  • Phone: 718-853-4327
  • Fax: 718-853-1754
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1381-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: