Healthcare Provider Details

I. General information

NPI: 1023624111
Provider Name (Legal Business Name): COSETTE GURULE HAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MADISON ST STE 201
DENVER CO
80206-5411
US

IV. Provider business mailing address

90 MADISON ST STE 201
DENVER CO
80206-5411
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-0054
  • Fax: 303-355-5879
Mailing address:
  • Phone: 303-322-0054
  • Fax: 303-355-5879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0000419
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: