Basic Information
| Provider Information | |||||||||
| NPI: | 1346288289 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAEMPFFE | ||||||||
| FirstName: | FREDERICK | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | IV | ||||||||
| Credential: | MD FAAOS FACS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 LANSING ST | ||||||||
| Address2: | AMMS, PC CREDENTIALING OFFICE | ||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130211983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152557438 | ||||||||
| FaxNumber: | 3152557099 | ||||||||
| Practice Location | |||||||||
| Address1: | 77 NELSON ST | ||||||||
| Address2: | SUITE #120 | ||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130211944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152527559 | ||||||||
| FaxNumber: | 3152538104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 07/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 1675491 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | 1675491 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | P010167549 | 01 | NY | BLUE CHOICE | OTHER | 01229441 | 05 | NY | MEDICAID |