1962784751 NPI number — MIROSLAWA GABRIELA HARI R.D.H.

Table of content: MIROSLAWA GABRIELA HARI R.D.H. (NPI 1962784751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962784751 NPI number — MIROSLAWA GABRIELA HARI R.D.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARI
Provider First Name:
MIROSLAWA
Provider Middle Name:
GABRIELA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D.H.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962784751
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
877 S BOULDER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80027-1345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-665-8228
Provider Business Mailing Address Fax Number:
303-665-8994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4155 DARLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOULDER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80305-6536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-499-7072
Provider Business Practice Location Address Fax Number:
303-665-8994
Provider Enumeration Date:
09/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 124Q00000X , with the licence number:  906374 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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