Healthcare Provider Details

I. General information

NPI: 1659313062
Provider Name (Legal Business Name): SENIOR CARE OF COLORADO, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S PEORIA ST SUITE 100
AURORA CO
80014-5476
US

IV. Provider business mailing address

2400 S PEORIA ST SUITE 100
AURORA CO
80014-5476
US

V. Phone/Fax

Practice location:
  • Phone: 303-306-4321
  • Fax: 303-369-3022
Mailing address:
  • Phone: 303-306-4321
  • Fax: 303-369-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL R WASSERMAN
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 303-306-4315