Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC005663 | PA |
Y | 222Z00000X | Podiatrist | SC005663 | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC005663 | PA |
N | 213ES0131X | Foot Surgery | SC005663 | PA |
NPI | 1427014521 |
---|---|
Provider Name | Dr. Jennifer O'brien Dempsey |
First Address | Scranton, PA 18510-1739 |
Second Address | Scranton, PA 18510-1739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 11/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016833350004 | (05) | PA |
1016833350006 | (05) | PA |
1016833350007 | (05) | PA |
1016933350003 | (05) | PA |
V09395 | (02) | PA |