MEDICARE: JUDITH KATHLEEN KREMPOSKY PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS003308L	PA

General Provider Information

NPI Number	:	1053332502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH KATHLEEN KREMPOSKY PHD

Provider Business Mailing Address
First Line	:	24 CEDAR AVE
Second Line	:
City	:	BLAIRSVILLE
State	:	PA
Zip	:	15717-1015
Country	:	US
Telephone Number	:	724-541-3262
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 SIDNEY ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1717
Country	:	US
Telephone Number	:	412-381-9141
Fax Number	:	412-381-7737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	05/13/2011

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