Healthcare Provider Details
I. General information
NPI: 1578100764
Provider Name (Legal Business Name): OREANN KEMPADOO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/06/2019
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 STEWART PL
SPRING VALLEY NY
10977-2335
US
IV. Provider business mailing address
7 STEWART PL
SPRING VALLEY NY
10977-2335
US
V. Phone/Fax
- Phone: 845-356-0274
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: