Healthcare Provider Details

I. General information

NPI: 1528922606
Provider Name (Legal Business Name): VITALY OLEG KHEYFETS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RESEARCH COMPLEX 2 12700 E. 19TH AVE.
AURORA CO
80045
US

IV. Provider business mailing address

8560 E TEMPLE DR
DENVER CO
80237-2960
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone: 913-568-4408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: