Provider Demographics
NPI:1942397120
Name:KERPEL, STANLEY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:M
Last Name:KERPEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BANKS FARM RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1914
Mailing Address - Country:US
Mailing Address - Phone:718-670-1520
Mailing Address - Fax:
Practice Address - Street 1:56-31 141ST STREET
Practice Address - Street 2:ORAL PATHOLOGY LABORATORY INC
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5016
Practice Address - Country:US
Practice Address - Phone:718-670-1520
Practice Address - Fax:718-445-4147
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029199-1122300000X, 1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDOE481Medicare ID - Type Unspecified
U18166Medicare UPIN