Provider Demographics
NPI:1043602261
Name:KEMP, PATRICK X (LICENSED PRACTICAL N)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:X
Last Name:KEMP
Suffix:
Gender:M
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 SEA GIRT BLVD
Mailing Address - Street 2:WEST LAWRENCE NURSING HOME
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691
Mailing Address - Country:US
Mailing Address - Phone:718-471-7000
Mailing Address - Fax:
Practice Address - Street 1:1410 SEA GIRT BLVD
Practice Address - Street 2:WEST LAWRENCE NURSING HOME
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691
Practice Address - Country:US
Practice Address - Phone:718-471-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313548-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse