Provider Demographics
NPI:1437319795
Name:KEMELMAN, ADRIENNE IRENE (RN)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:IRENE
Last Name:KEMELMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ADRIENNE
Other - Middle Name:IRENE
Other - Last Name:LERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2410 KINGS HWY APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1647
Mailing Address - Country:US
Mailing Address - Phone:718-630-3558
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:RM 6-231
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-630-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY385777-1163W00000X
NJ26NR10173200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse