Provider Demographics
NPI:1346288289
Name:KAEMPFFE, FREDERICK IV (MD FAAOS FACS)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:KAEMPFFE
Suffix:IV
Gender:M
Credentials:MD FAAOS FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANSING ST
Mailing Address - Street 2:AMMS, PC CREDENTIALING OFFICE
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-255-7438
Mailing Address - Fax:315-255-7099
Practice Address - Street 1:77 NELSON ST
Practice Address - Street 2:SUITE #120
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1944
Practice Address - Country:US
Practice Address - Phone:315-252-7559
Practice Address - Fax:315-253-8104
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1675491207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010167549OtherBLUE CHOICE
NY01229441Medicaid
NY01229441Medicaid
NYJ400001116Medicare PIN