Basic Information
| Provider Information | |||||||||
| NPI: | 1003922626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUFFMAN | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 32 | ||||||||
| Address2: | PROCLAIM INC | ||||||||
| City: | ANDOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032160032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037356060 | ||||||||
| FaxNumber: | 6037356070 | ||||||||
| Practice Location | |||||||||
| Address1: | 580 ST. JOHNSBURY RD | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034449000 | ||||||||
| FaxNumber: | 8454546080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 11/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G85116 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | G85116 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207XX0005X | 199620 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207X00000X | 199620 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 02090146 | 05 | NY | MEDICAID |