Healthcare Provider Details

I. General information

NPI: 1144163668
Provider Name (Legal Business Name): MIKAYLA J KEMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2277 S UNION ST
SPENCERPORT NY
14559-2225
US

IV. Provider business mailing address

2361 N HAMLIN RD
HAMLIN NY
14464-9760
US

V. Phone/Fax

Practice location:
  • Phone: 585-349-3300
  • Fax:
Mailing address:
  • Phone: 585-727-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011396
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: