1558533356 NPI number — VINCENT BRENDAN HERLIHY M.D.

Table of content: VINCENT BRENDAN HERLIHY M.D. (NPI 1558533356)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558533356 NPI number — VINCENT BRENDAN HERLIHY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERLIHY
Provider First Name:
VINCENT
Provider Middle Name:
BRENDAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1558533356
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1746 COLE BLVD
Provider Second Line Business Mailing Address:
STE 150
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80401-3208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-716-3787
Provider Business Mailing Address Fax Number:
303-716-3777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
938 BANNOCK ST
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-4028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-716-3787
Provider Business Practice Location Address Fax Number:
303-716-3777
Provider Enumeration Date:
04/01/2008

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: 2085R0202X , with the licence number:  6918010-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 47783 , 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)





Copyright © 2007-2025 www.npivalidator.com