Provider Demographics
NPI:1124191036
Name:KAMPFER, PATRICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:KAMPFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BROADWAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701
Mailing Address - Country:US
Mailing Address - Phone:631-598-3535
Mailing Address - Fax:631-598-3572
Practice Address - Street 1:116 BROADWAY
Practice Address - Street 2:SUITE 3
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-598-3535
Practice Address - Fax:631-598-3572
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004943111N00000X
FL5722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X3086Medicare ID - Type Unspecified