Healthcare Provider Details

I. General information

NPI: 1639516206
Provider Name (Legal Business Name): DANIEL G. KAUFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 11/07/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 ROUTE 52
CARMEL NY
10512-1200
US

IV. Provider business mailing address

150 ROUTE 52
CARMEL NY
10512-1200
US

V. Phone/Fax

Practice location:
  • Phone: 845-228-2910
  • Fax:
Mailing address:
  • Phone: 845-228-2910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number75559
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number302611
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number256140
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: