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NPI Code Detail

MEDICARE: MS. DENISE GERDA BASCH PA

MEDICARE: MS. DENISE GERDA BASCH PA
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
1363A00000XPhysician AssistantPA0003596CO

General Provider Information

NPI Number : 1194977181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENISE GERDA BASCH PA
Provider Business Mailing Address
First Line : PO BOX 746081
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6081
Country : US
Telephone Number : 312-733-9730
Fax Number : 620-506-4813
Provider Business Practice Location Address
First Line : 5996 E 64TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-3317
Country : US
Telephone Number : 720-463-6758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2008
Last Update Date : 08/03/2023

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