MEDICARE: LAURIE B KAUFMAN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS01148	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M18708	OTHER	MA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	685661	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1073648572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE B KAUFMAN PH.D.

Provider Business Mailing Address
First Line	:	44 SPRING ST
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-2459
Country	:	US
Telephone Number	:	401-213-5188
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 ROBINSON ST
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3656
Country	:	US
Telephone Number	:	401-213-5188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	12/01/2025

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