Healthcare Provider Details

I. General information

NPI: 1427293471
Provider Name (Legal Business Name): C.J. TSAMASFYROS, M.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 9TH AVE SUITE 220
DENVER CO
80220-3912
US

IV. Provider business mailing address

4500 E 9TH AVE SUITE 220
DENVER CO
80220-3912
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-2005
  • Fax: 303-322-4408
Mailing address:
  • Phone: 303-322-2005
  • Fax: 303-322-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number17165
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number17165
License Number StateCO

VIII. Authorized Official

Name: CONSTANTINE J TSAMASFYROS
Title or Position: MANAGER
Credential: MD
Phone: 303-322-2005