MEDICARE: DR. ALEXANDRA TALABER O.D.

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	152W00000X	Optometrist	046010843	IL
2	152WV0400X	Vision Therapy Optometrist	007905	NY
3	152WV0400X	Vision Therapy Optometrist	3236	CO

General Provider Information

NPI Number	:	1891041661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA TALABER O.D.

Provider Business Mailing Address
First Line	:	300 S JACKSON ST STE 320
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-3134
Country	:	US
Telephone Number	:	720-408-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S JACKSON ST STE 320
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-3134
Country	:	US
Telephone Number	:	720-408-1400
Fax Number	:	720-408-1437

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	12/11/2019

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