Basic Information
| Provider Information | |||||||||
| NPI: | 1922096965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEMPSEY | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 SPRUCE STREET | ||||||||
| Address2: | 4 SILVERSTEIN | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622626 | ||||||||
| FaxNumber: | 2157073945 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 SPRUCE STREET | ||||||||
| Address2: | 4 SILVERSTEIN | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622626 | ||||||||
| FaxNumber: | 2157073945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 06/02/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD025159E | PA | Y | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | MD025159E | PA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
ID Information
| ID | Type | State | Issuer | Description | 0010478990006 | 05 | PA | MEDICAID |