Provider Demographics
NPI:1619489507
Name:KEMPTER, RICHARD (PSY)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KEMPTER
Suffix:
Gender:M
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 E 72ND ST APT 8B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4686
Mailing Address - Country:US
Mailing Address - Phone:917-509-1132
Mailing Address - Fax:
Practice Address - Street 1:353 E 72ND ST APT 8B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4686
Practice Address - Country:US
Practice Address - Phone:917-509-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002621103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6301002621OtherPSY LICENSE