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General NPI Number Information
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NPI Number | 1760668842
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Entity Type | Organization
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Legal Business Name | JAVIER WAKSMAN MD,PC.
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2545
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Country | US
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Telephone | 720-848-0000
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Fax | 303-316-7942
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Provider Business Mailing Address
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Address Line | 13611 E COLFAX AVE
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City | AURORA
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State | CO
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Zip | 80045-5701
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Country | US
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Telephone | 303-493-7000
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Fax | 303-316-7942
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAVIER WAKSMAN
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Credential |
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Telephone | 303-493-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 39764
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License Number State | CO
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