Basic Information
| Provider Information | |||||||||
| NPI: | 1518154970 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 CRANBERRY CT | ||||||||
| Address2: | |||||||||
| City: | MELVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117478722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312498707 | ||||||||
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| Practice Location | |||||||||
| Address1: | 189 WHEATLEY ROAD | ||||||||
| Address2: | |||||||||
| City: | BROOKVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166261000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R054201 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.