Basic Information
| Provider Information | |||||||||
| NPI: | 1669708798 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADLER | ||||||||
| FirstName: | SIDNEY | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., F.A.C.O.G. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6355 S BUFFALO DR FL 3 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891132133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022163346 | ||||||||
| FaxNumber: | 7026716883 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 JASPER PEAK CT | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800268889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038594433 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2009 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 48131 | CO | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 197414 | NY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 18468 | NV | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 73908339 | 05 | CO | MEDICAID |