Healthcare Provider Details

I. General information

NPI: 1154381846
Provider Name (Legal Business Name): HOWARD KAUFMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 BROADWAY
NEW YORK NY
10007-3001
US

IV. Provider business mailing address

225 BROADWAY
NEW YORK NY
10007-3001
US

V. Phone/Fax

Practice location:
  • Phone: 212-732-7400
  • Fax: 212-732-0267
Mailing address:
  • Phone: 212-732-7400
  • Fax: 212-732-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number024520
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: