MEDICARE: ERIC REMZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		CO

General Provider Information

NPI Number	:	1174121107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC REMZA

Provider Business Mailing Address
First Line	:	1004 PORTLAND PL APT E
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-8214
Country	:	US
Telephone Number	:	206-300-3754
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 47TH ST STE 130
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-1802
Country	:	US
Telephone Number	:	303-225-2708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2020
Last Update Date	:	10/12/2020

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Directions to “ ERIC REMZA ” Practice Location

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