Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist | ||
Y | 224P00000X | Prosthetist | CB115612 | PA |
NPI | 1346884988 |
---|---|
Provider Name | Ms. Tenell Denise Dorsey |
First Address | Pittsburgh, PA 15221-1417 |
Second Address | Homestead, PA 15120-1504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2019 |
Last Update Date | 06/11/2019 |