Provider Demographics
NPI:1851713465
Name:KIEMPISTY, LORI
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:KIEMPISTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 STATE ROUTE 27
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3979
Mailing Address - Country:US
Mailing Address - Phone:732-545-7474
Mailing Address - Fax:732-545-2880
Practice Address - Street 1:1527 STATE ROUTE 27
Practice Address - Street 2:SUITE 1100
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3979
Practice Address - Country:US
Practice Address - Phone:732-545-7474
Practice Address - Fax:732-545-2880
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00298000225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant