Provider Demographics
NPI:1760744510
Name:DEMPSTER, AGNES (MSED)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:DEMPSTER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1470
Mailing Address - Country:US
Mailing Address - Phone:845-238-6608
Mailing Address - Fax:
Practice Address - Street 1:343 VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2332
Practice Address - Country:US
Practice Address - Phone:845-691-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist