Provider Demographics
NPI:1316106941
Name:KREMPA, JANIS LYNN (MED, BCBA)
Entity type:Individual
Prefix:MS
First Name:JANIS
Middle Name:LYNN
Last Name:KREMPA
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SOUNDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1748
Mailing Address - Country:US
Mailing Address - Phone:617-852-7899
Mailing Address - Fax:
Practice Address - Street 1:111 SOUNDVIEW DR
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1748
Practice Address - Country:US
Practice Address - Phone:617-852-7899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-03-1336103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst