MEDICARE: LORI WARANCH BEKENSTEIN MD

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	2084P0800X	Psychiatry Physician	47142	VA

General Provider Information

NPI Number	:	1316151277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI WARANCH BEKENSTEIN MD

Provider Business Mailing Address
First Line	:	5117 HARVEST GLEN DRIVE
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059
Country	:	US
Telephone Number	:	804-364-7026
Fax Number	:	804-364-7026

Provider Business Practice Location Address
First Line	:	1300 WEST BROAD STREET
Second Line	:	SPORTS MEDICINE BUILDING SUITE 2200
City	:	RICHMOND
State	:	VA
Zip	:	23284-2022
Country	:	US
Telephone Number	:	804-828-8828
Fax Number	:	804-828-6688

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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