1245277441 NPI number — SETH A KAUFMAN M.D.

Table of content: SETH A KAUFMAN M.D. (NPI 1245277441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245277441 NPI number — SETH A KAUFMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUFMAN
Provider First Name:
SETH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1245277441
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 KIMBALL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01506-1638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-636-6161
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 WASHINGTON STREET, BOX 359
Provider Second Line Business Practice Location Address:
NEW ENGLAND MEDICAL CENTER
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-636-6161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2006

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: 2085R0001X , with the licence number:  226435 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000140134 . This is a "BOSTON MEDICAL CENTER THROUGH VALLEY HEALTH PHO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 93830202 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA452173 . This is a "HARVARD PILGRIM AND TUFTS THROUGH VALLEY HEALTH PHO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J40104 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P01444702 . This is a "RR MEDICARE ID #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7105716 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1555908 . This is a "COVENTRY INDIV. ID #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1245277441 . This is a "MASS HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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