MEDICARE: ROBERT PAINTER

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1285094631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT PAINTER

Provider Business Mailing Address
First Line	:	3200 W 14TH AVE
Second Line	:	APT. 675
City	:	DENVER
State	:	CO
Zip	:	80204-2290
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 W 14TH AVE
Second Line	:	APT. 675
City	:	DENVER
State	:	CO
Zip	:	80204-2290
Country	:	US
Telephone Number	:	914-841-8804
Fax Number	:

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

Provider Enumeration Date	:	02/28/2016
Last Update Date	:	02/28/2016

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Directions to “ ROBERT PAINTER ” Practice Location

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