Provider Demographics
NPI:1316151277
Name:BEKENSTEIN, LORI WARANCH (MD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:WARANCH
Last Name:BEKENSTEIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5117 HARVEST GLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059
Mailing Address - Country:US
Mailing Address - Phone:804-364-7026
Mailing Address - Fax:804-364-7026
Practice Address - Street 1:1300 WEST BROAD STREET
Practice Address - Street 2:SPORTS MEDICINE BUILDING SUITE 2200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23284-2022
Practice Address - Country:US
Practice Address - Phone:804-828-8828
Practice Address - Fax:804-828-6688
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA471422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F43648Medicare UPIN