Healthcare Provider Details
I. General information
NPI: 1376664383
Provider Name (Legal Business Name): TRASA ROSSINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1136 ALPINE AVE SUITE 225
BOULDER CO
80304-3405
US
IV. Provider business mailing address
PO BOX 20160
BOULDER CO
80308-3160
US
V. Phone/Fax
- Phone: 303-447-3380
- Fax: 303-440-0489
- Phone: 303-516-4852
- Fax: 303-516-4852
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZS0410X |
| Taxonomy | Surgical Technologist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: