Basic Information
| Provider Information | |||||||||
| NPI: | 1598367955 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLORADO HEART AND VASCULAR PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11700 W 2ND PL STE 350 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035952727 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2030 MOUNTAIN VIEW AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805013181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035154651 | ||||||||
| FaxNumber: | 3037722171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2020 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | PIETRZYK | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 3035952727 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.