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NPI Code Detail

MEDICARE: YULIYA MEZENTSEVA

MEDICARE: YULIYA MEZENTSEVA
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 Assistant
2363A00000XPhysician AssistantPA.8985CO

General Provider Information

NPI Number : 1750119913
Entity Type Code : Individual
Provider Name (Legal Business Name) : YULIYA MEZENTSEVA
Provider Business Mailing Address
First Line : 12596 W BAYAUD AVE STE 100
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-2035
Country : US
Telephone Number : 720-638-7500
Fax Number : 720-812-5134
Provider Business Practice Location Address
First Line : 12596 W BAYAUD AVE STE 100
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-2035
Country : US
Telephone Number : 720-638-7500
Fax Number : 720-812-5134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 02/25/2025

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Directions to “ YULIYA MEZENTSEVA ” Practice Location

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