Basic Information
| Provider Information | |||||||||
| NPI: | 1447780853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COVI | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | MICHELE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 308 INCA STREET | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 80223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038186704 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11700 W 2ND PL STE 350 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035952727 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2017 | ||||||||
| LastUpdateDate: | 09/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 1013227651 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 363A00000X | PA.0005078 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.