Healthcare Provider Details

I. General information

NPI: 1922610682
Provider Name (Legal Business Name): KAUFMAN ALLERGY ASTHMA AND IMMUNOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2020
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 OLD GALLOWS RD STE 205
VIENNA VA
22182-3931
US

IV. Provider business mailing address

1945 OLD GALLOWS RD STE 205
VIENNA VA
22182-3931
US

V. Phone/Fax

Practice location:
  • Phone: 703-403-5413
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN BETH KAUFMAN
Title or Position: PHYSICIAN, OWNER
Credential: DO
Phone: 305-975-3356