MEDICARE: DR. THOMAS DONALD KEMPTON PH.D.

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	103T00000X	Psychologist	008412-1	NY

General Provider Information

NPI Number	:	1740485325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS DONALD KEMPTON PH.D.

Provider Business Mailing Address
First Line	:	117 CENTERSHORE RD
Second Line	:
City	:	CENTERPORT
State	:	NY
Zip	:	11721-1346
Country	:	US
Telephone Number	:	631-754-1853
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 DEER PARK AVE
Second Line	:
City	:	DEER PARK
State	:	NY
Zip	:	11729-2701
Country	:	US
Telephone Number	:	631-667-3667
Fax Number	:

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	07/08/2007

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