MEDICARE: ELENA ILIEVA PASKOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MT-12963	CO
2	174400000X	Specialist	PT 0012076	CO

General Provider Information

NPI Number	:	1699036491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA ILIEVA PASKOVA

Provider Business Mailing Address
First Line	:	1273 S MONACO PKWY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-1811
Country	:	US
Telephone Number	:	720-277-8578
Fax Number	:

Provider Business Practice Location Address
First Line	:	3955 E EXPOSITION AVE STE 320
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-5033
Country	:	US
Telephone Number	:	303-777-1151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	03/21/2014

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Directions to “ ELENA ILIEVA PASKOVA ” Practice Location

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