Basic Information
Provider Information
NPI: 1689315988
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEMPLER
FirstName: EMILY
MiddleName: RAE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2166 W 34TH PL
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441133975
CountryCode: US
TelephoneNumber: 8138028146
FaxNumber:  
Practice Location
Address1: 27155 CHARDON RD STE 201
Address2:  
City: RICHMOND HEIGHTS
State: OH
PostalCode: 441431166
CountryCode: US
TelephoneNumber: 4405856553
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2022
LastUpdateDate: 04/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X58.032657OHN Allopathic & Osteopathic PhysiciansFamily Medicine 
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home