Provider Demographics
NPI:1487938650
Name:TEMPEL, KIRSTEN MARIE (LAC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:TEMPEL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:MARIE
Other - Last Name:TEMPEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:116 BERKELEY PLACE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:917-690-1180
Mailing Address - Fax:
Practice Address - Street 1:137 GRAND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3143
Practice Address - Country:US
Practice Address - Phone:917-690-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004609171100000X
CT589171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist