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General NPI Number Information
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NPI Number | 1992236103
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Entity Type | Organization
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Legal Business Name | ELIAZ KAUFMAN DDS PLLC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 55 AVENUE C GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10009-6855
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Country | US
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Telephone | 201-310-0289
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Fax |
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Provider Business Mailing Address
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Address Line | 55 AVENUE C GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10009-6855
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIAZ KAUFMAN
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Credential | DDS MS
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Telephone | 201-310-0289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 49860
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49860
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License Number State | NY
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