Provider Demographics
NPI:1861129199
Name:KAUFFMAN, ZACHARY THOMAS (PT)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:THOMAS
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 TILDEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1434
Mailing Address - Country:US
Mailing Address - Phone:856-725-7936
Mailing Address - Fax:
Practice Address - Street 1:37464 LION DRIVE
Practice Address - Street 2:STE 4
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975
Practice Address - Country:US
Practice Address - Phone:302-988-1586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030644225100000X
DEJ1-0014840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty