Basic Information
| Provider Information | |||||||||
| NPI: | 1730259706 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DIAMOND HILL RD | ||||||||
| Address2: | |||||||||
| City: | BERKELEY HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079222104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082734300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31-00 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | FAIR LAWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074103963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017962255 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 11/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA05138600 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.