Provider Demographics
NPI:1619765385
Name:EMPIRE WELLNESS PHYSICIAN PC
Entity type:Organization
Organization Name:EMPIRE WELLNESS PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:KLEMPEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-476-4000
Mailing Address - Street 1:991 MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1608
Mailing Address - Country:US
Mailing Address - Phone:631-476-4000
Mailing Address - Fax:
Practice Address - Street 1:991 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-1608
Practice Address - Country:US
Practice Address - Phone:631-476-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty