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NPI Code Detail

MEDICARE: OUTPATIENT MANAGEMENT PHYSICIAN SERVICES ESSEX LLC

MEDICARE: OUTPATIENT MANAGEMENT PHYSICIAN SERVICES ESSEX LLC
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
1207L00000XAnesthesiology Physician25MA04313600NJ

General Provider Information

NPI Number : 1922262351
Entity Type Code : Organization
Provider Name (Legal Business Name) : OUTPATIENT MANAGEMENT PHYSICIAN SERVICES ESSEX LLC
Provider Business Mailing Address
First Line : 5 PATRIOTS FARM PL
Second Line :
City : ARMONK
State : NY
Zip : 10504-2810
Country : US
Telephone Number : 914-725-8855
Fax Number : 914-725-8877
Provider Business Practice Location Address
First Line : 1460 BROAD ST
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3014
Country : US
Telephone Number : 914-725-8855
Fax Number : 914-725-8877
Authorized Official
Title or Position : OWNER
Name : DR. BRUCE D KAUFMAN
Credential : MD
Telephone Number : 914-725-8855
Provider Enumeration Date : 07/15/2008
Last Update Date : 07/07/2009

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Directions to “OUTPATIENT MANAGEMENT PHYSICIAN SERVICES ESSEX LLC ” Practice Location

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