Basic Information
| Provider Information | |||||||||
| NPI: | 1396785093 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEMPSEY | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | GERARD | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 7 DOCK HILL RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178428910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708372123 | ||||||||
| FaxNumber: | 5708372185 | ||||||||
| Practice Location | |||||||||
| Address1: | 1244 STATE ROUTE 225 | ||||||||
| Address2: | |||||||||
| City: | HERNDON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178307324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707583511 | ||||||||
| FaxNumber: | 5707584736 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | OS008867L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 208000000X | OS008867L | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | OS008867L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0016072410012 | 05 | PA | MEDICAID | 0016072410005 | 05 | PA | MEDICAID |