Healthcare Provider Details

I. General information

NPI: 1336004910
Provider Name (Legal Business Name): LARYNN KAUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LARYNN BLAIR

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAIN ST
DENVER PA
17517-1610
US

IV. Provider business mailing address

418 FLAXEN LN
EPHRATA PA
17522-8443
US

V. Phone/Fax

Practice location:
  • Phone: 717-875-1655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW140206
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: