Provider Demographics
NPI:1659608933
Name:KUEMMEL, HANNAH MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:KUEMMEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2802
Mailing Address - Country:US
Mailing Address - Phone:631-474-2723
Mailing Address - Fax:
Practice Address - Street 1:15 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2802
Practice Address - Country:US
Practice Address - Phone:631-474-2723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0018382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer