Healthcare Provider Details

I. General information

NPI: 1164446894
Provider Name (Legal Business Name): JEFFREY KAUFFMAN M.S.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 POTTSTWON PIKE
CHESTER SPRINGS PA
19425
US

IV. Provider business mailing address

PO BOX 155
SAINT PETERS PA
19470-0155
US

V. Phone/Fax

Practice location:
  • Phone: 610-310-0136
  • Fax:
Mailing address:
  • Phone: 610-310-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW-002245-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: