Healthcare Provider Details

I. General information

NPI: 1225341449
Provider Name (Legal Business Name): ZUCKER GERIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 S BUCKLEY RD # 267
AURORA CO
80013-2951
US

IV. Provider business mailing address

4255 S BUCKLEY RD # 267
AURORA CO
80013-2951
US

V. Phone/Fax

Practice location:
  • Phone: 303-351-6450
  • Fax: 303-945-4913
Mailing address:
  • Phone: 303-351-6450
  • Fax: 303-945-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number257460943
License Number StateCO

VIII. Authorized Official

Name: JOSHUA ZUCKER
Title or Position: OWNER
Credential: NP
Phone: 303-351-6450