1437120391 NPI number — DR. KATHY M KAUFMAN CRNP,PHD,LPC,NCC,BSN

Table of content: DR. KATHY M KAUFMAN CRNP,PHD,LPC,NCC,BSN (NPI 1437120391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437120391 NPI number — DR. KATHY M KAUFMAN CRNP,PHD,LPC,NCC,BSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUFMAN
Provider First Name:
KATHY
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
CRNP,PHD,LPC,NCC,BSN
Provider Gender Code:
F

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:
1437120391
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 N CEDAR CREST BLVD
Provider Second Line Business Mailing Address:
STE. 618
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-2351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-435-2420
Provider Business Mailing Address Fax Number:
610-435-2620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1040 CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMMAUS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18049-1952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-966-5549
Provider Business Practice Location Address Fax Number:
610-967-0204
Provider Enumeration Date:
01/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC002267 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: SP015380 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7376376 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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