MEDICARE: LORNA DEMPSTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	301699-1	NY

General Provider Information

NPI Number	:	1306150339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNA DEMPSTER

Provider Business Mailing Address
First Line	:	4016 BRUNER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2229
Country	:	US
Telephone Number	:	754-246-8122
Fax Number	:

Provider Business Practice Location Address
First Line	:	4016 BRUNER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2229
Country	:	US
Telephone Number	:	754-246-8122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2010
Last Update Date	:	08/02/2010

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Directions to “ LORNA DEMPSTER ” Practice Location

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