Provider Demographics
NPI:1710470646
Name:KAUFMAN, ALICE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-3498
Mailing Address - Country:US
Mailing Address - Phone:802-257-0341
Mailing Address - Fax:802-257-8834
Practice Address - Street 1:21 BELMONT AVE STE 1
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6762
Practice Address - Country:US
Practice Address - Phone:802-251-8455
Practice Address - Fax:802-251-8412
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA276026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine