MEDICARE: MISS MOHINI PATHRIA

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	207K00000X	Allergy & Immunology Physician	35.135856	OH
2	207R00000X	Internal Medicine Physician	35.135856	OH
3	207K00000X	Allergy & Immunology Physician	DR.0065981	CO

General Provider Information

NPI Number	:	1609296268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MOHINI PATHRIA

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 COOK ST STE 400
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-5340
Country	:	US
Telephone Number	:	720-516-9401
Fax Number	:	720-516-9429

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

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	07/12/2021

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Directions to “ MISS MOHINI PATHRIA ” Practice Location

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