Healthcare Provider Details

I. General information

NPI: 1699814095
Provider Name (Legal Business Name): CONSTANCE A ZASTROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST
DENVER CO
80205-5437
US

IV. Provider business mailing address

8501 W UNION AVE UNIT 26
DENVER CO
80123-1887
US

V. Phone/Fax

Practice location:
  • Phone: 303-764-5504
  • Fax:
Mailing address:
  • Phone: 303-948-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2901X
TaxonomyCardiovascular Invasive Specialist/Technologist
License Number109030
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: