Provider Demographics
NPI:1730234832
Name:KAUFMAN, KAREN BETH (DO)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:BETH
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:BETH
Other - Last Name:JACOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1945 OLD GALLOWS RD STE 205
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1945 OLD GALLOWS RD STE 205
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3931
Practice Address - Country:US
Practice Address - Phone:703-403-5413
Practice Address - Fax:833-314-0496
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204174207KA0200X, 207KI0005X, 207RA0201X, 2080P0201X, 207K00000X
LADO.000203207RA0201X
NENE526207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
84512Medicare UPIN