Provider Demographics
NPI:1356482715
Name:KEPPEL, EMMA J (ANP)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:J
Last Name:KEPPEL
Suffix:
Gender:F
Credentials:ANP
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Mailing Address - Street 1:116 44 168 STREET
Mailing Address - Street 2:ST. ALBAN'S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11434
Mailing Address - Country:US
Mailing Address - Phone:917-399-1345
Mailing Address - Fax:212-636-3297
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:NEW YORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-636-3400
Practice Address - Fax:212-636-3297
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF302260-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF302260-1OtherLICENSE NUMBER