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NPI Code Detail

MEDICARE: BIRUTAWIT ZELALEM BURUKIE BB

MEDICARE:   BIRUTAWIT ZELALEM BURUKIE  BB
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
1224ZR0403XDriving and Community Mobility Occupational Therapy Assistant

General Provider Information

NPI Number : 1457040412
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIRUTAWIT ZELALEM BURUKIE BB
Provider Business Mailing Address
First Line : 2133 CENTRAL PARK BLVD
Second Line :
City : DENVER
State : CO
Zip : 80238-4115
Country : US
Telephone Number : 720-329-5307
Fax Number :
Provider Business Practice Location Address
First Line : 2133 CENTRAL PARK BLVD
Second Line :
City : DENVER
State : CO
Zip : 80238-4115
Country : US
Telephone Number : 720-329-5307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2023
Last Update Date : 05/04/2023

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Directions to “ BIRUTAWIT ZELALEM BURUKIE BB” Practice Location

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