Healthcare Provider Details

I. General information

NPI: 1649253121
Provider Name (Legal Business Name): RICHARD L. KAUFMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 FRONT ST
UNIONDALE NY
11553-1642
US

IV. Provider business mailing address

955 FRONT ST
UNIONDALE NY
11553-1642
US

V. Phone/Fax

Practice location:
  • Phone: 516-481-1177
  • Fax: 516-485-6926
Mailing address:
  • Phone: 516-481-1177
  • Fax: 516-485-6926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number034858
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: