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General NPI Number Information
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NPI Number | 1487282992
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Entity Type | Organization
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Legal Business Name | NEUROLOGY INSTITUTE OF COLORADO, PLLC
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 433 SUMMIT BLVD UNIT 201
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City | BROOMFIELD
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State | CO
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Zip | 80021-8299
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Country | US
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Telephone | 830-896-8080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 293879
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City | KERRVILLE
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State | TX
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Zip | 78029-3879
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Country | US
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Telephone | 830-896-8080
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | SUZANNE K GAZDA
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Credential | MD
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Telephone | 830-896-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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