Provider Demographics
NPI:1649238247
Name:DEMPSEY, KENNETH G (PT)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:G
Last Name:DEMPSEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BUNCE RD
Mailing Address - Street 2:
Mailing Address - City:ASHLEY FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01222-9501
Mailing Address - Country:US
Mailing Address - Phone:413-229-0393
Mailing Address - Fax:
Practice Address - Street 1:777 S MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2140
Practice Address - Country:US
Practice Address - Phone:413-644-0110
Practice Address - Fax:413-644-0112
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9926225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY67232OtherBLUE CROSS OF MA
CT080007412CT01OtherANTHEM BC/BS
MA9353253OtherPHCS
MAY67232OtherBLUE CROSS OF MA
MA9353253OtherPHCS