MEDICARE: HOWARD KAUFMAN M.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	208000000X	Pediatrics Physician	110730-1	NY
2	208000000X	Pediatrics Physician	25MA03940800	NJ
3	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	1156

General Provider Information

NPI Number	:	1134154099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD KAUFMAN M.D.

Provider Business Mailing Address
First Line	:	885 QUEEN ANNE RD
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-4642
Country	:	US
Telephone Number	:	201-723-0278
Fax Number	:	201-862-1008

Provider Business Practice Location Address
First Line	:	885 QUEEN ANNE RD
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-4642
Country	:	US
Telephone Number	:	201-723-0278
Fax Number	:

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	05/14/2014

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