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General NPI Number Information
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NPI Number | 1619203924
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Entity Type | Organization
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Legal Business Name | BRENT THOMAS KEMPF, D.P.M.
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 110 LAKELAND AVE
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City | SAYVILLE
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State | NY
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Zip | 11782-1912
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Country | US
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Telephone | 631-567-2888
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Fax | 631-567-2369
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Provider Business Mailing Address
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Address Line | 110 LAKELAND AVE
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City | SAYVILLE
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State | NY
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Zip | 11782-1912
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Country | US
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Telephone | 631-567-2888
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Fax | 631-567-2369
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRENT THOMAS KEMPF
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Credential | D.P.M.
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Telephone | 631-567-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N005677
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License Number State | NY
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