1598901076 NPI number — MISS GALIA LILLIANA SPYCHALSKA FNP

Table of content: MISS GALIA LILLIANA SPYCHALSKA FNP (NPI 1598901076)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598901076 NPI number — MISS GALIA LILLIANA SPYCHALSKA FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPYCHALSKA
Provider First Name:
GALIA
Provider Middle Name:
LILLIANA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1598901076
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
720 S COLORADO BLVD
Provider Second Line Business Mailing Address:
SUITE 220A
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80246-1912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-301-9010
Provider Business Mailing Address Fax Number:
303-832-3721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 EAST 19TH AVE
Provider Second Line Business Practice Location Address:
SUITE 6600
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80218-1292
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-301-9010
Provider Business Practice Location Address Fax Number:
303-832-3721
Provider Enumeration Date:
01/05/2009

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: 363LF0000X , with the licence number:  NP18696 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1598901076 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55277870 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025764100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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