MEDICARE: JOSEPH ANDREW DEMBEK

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1245081504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ANDREW DEMBEK

Provider Business Mailing Address
First Line	:	3047 CAROLINE AVE
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-1439
Country	:	US
Telephone Number	:	440-222-5422
Fax Number	:

Provider Business Practice Location Address
First Line	:	3047 CAROLINE AVE
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-1439
Country	:	US
Telephone Number	:	440-222-5422
Fax Number	:

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

Provider Enumeration Date	:	03/27/2024
Last Update Date	:	03/27/2024

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