Healthcare Provider Details

I. General information

NPI: 1134500978
Provider Name (Legal Business Name): HABEN GEBRAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3784 S URAVAN WAY
AURORA CO
80013-3421
US

IV. Provider business mailing address

3784 S URAVAN WAY
AURORA CO
80013-3421
US

V. Phone/Fax

Practice location:
  • Phone: 720-628-1658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberB9966
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: