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General NPI Number Information
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NPI Number | 1245756808
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Entity Type | Individual
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Provider Name | KATHRYN M SEMMELROCK AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 20 PROSPECT AVE
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City | HACKENSACK
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State | NJ
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Zip | 07601-1997
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Country | US
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Telephone | 551-996-4424
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Fax | 551-996-0831
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Provider Business Mailing Address
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Address Line | 170 MAPLE AVE STE 502
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4708
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Country | US
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Telephone | 914-948-1000
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Fax | 914-949-5860
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 308316
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ01049100
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License Number State | NJ
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