Provider Demographics
NPI:1972767465
Name:EILEEN KEMETHER MD PC
Entity Type:Organization
Organization Name:EILEEN KEMETHER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLI NG MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-449-6970
Mailing Address - Street 1:903 PARK AVE
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0338
Mailing Address - Country:US
Mailing Address - Phone:212-737-1898
Mailing Address - Fax:212-273-1898
Practice Address - Street 1:903 PARK AVE
Practice Address - Street 2:SUITE 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0338
Practice Address - Country:US
Practice Address - Phone:212-737-1898
Practice Address - Fax:212-273-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1959942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY45M442Medicare PIN