Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS009083L | PA |
N | 207QA0401X | Family Doctor - Addiction Medicine | OS009083L | PA |
N | 208D00000X | General Practice Physician | OS-009083L | PA |
NPI | 1124137088 |
---|---|
Provider Name | Stuart A. Kauffman |
First Address | Huntingdon Valley, PA 19006-4242 |
Second Address | Huntingdon Valley, PA 19006-4242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 04/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G43994 | (02) | PA |