Healthcare Provider Details

I. General information

NPI: 1336429026
Provider Name (Legal Business Name): LORELEI D. MCCLOSKEY DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORELEI D LAM DPM

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 CENTRAL PARK BLVD UNIT 201
DENVER CO
80238-2300
US

IV. Provider business mailing address

2373 CENTRAL PARK BLVD UNIT 201
DENVER CO
80238-2300
US

V. Phone/Fax

Practice location:
  • Phone: 303-577-0110
  • Fax: 303-577-0112
Mailing address:
  • Phone: 303-577-0110
  • Fax: 303-577-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number741
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: