1336344712 NPI number — KAUFMAN PSYCHOTHERAPY ASSOCIATES LLC

Table of content: (NPI 1336344712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336344712 NPI number — KAUFMAN PSYCHOTHERAPY ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAUFMAN PSYCHOTHERAPY ASSOCIATES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336344712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 SUMMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06905-5542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-363-0793
Provider Business Mailing Address Fax Number:
203-363-0794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 SUMMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06905-5542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-363-0793
Provider Business Practice Location Address Fax Number:
203-363-0794
Provider Enumeration Date:
06/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAUFMAN
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
MARGARET
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
203-363-0793

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  2597 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1336344712 . This is a "GOLDEN RULE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1336344712 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1336344712 . This is a "PACIFICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1700914538 . This is a "INDIVIDUAL NPI NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5335019 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1336344712 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 403348 . This is a "MHN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 800004226 . This is a "MEDICARE INDIVIDUAL PTAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: ZS608 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 09441 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 140002597CT05 . This is a "ANTHEM LCSW" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 158568 . This is a "GHI/ VALUE OPTIONS-BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 158568 . This is a "VALUE OPTIONS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 300000459CT05 . This is a "ANTHEM LADC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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