Healthcare Provider Details

I. General information

NPI: 1891312013
Provider Name (Legal Business Name): ALL MY RELATIONS DR TONY BANDELE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 S TROY ST STE 3-107
AURORA CO
80014-1982
US

IV. Provider business mailing address

1467 S JASPER ST
AURORA CO
80017-4028
US

V. Phone/Fax

Practice location:
  • Phone: 303-921-3633
  • Fax:
Mailing address:
  • Phone: 303-921-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY BANDELE
Title or Position: OWNER
Credential:
Phone: 303-921-3633