MEDICARE: TELAL ABDELLATIF

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	172A00000X	Driver	LL02820	CO

General Provider Information

NPI Number	:	1922473792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TELAL ABDELLATIF

Provider Business Mailing Address
First Line	:	7474 E ARKANSAS AVE APT 2408
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2544
Country	:	US
Telephone Number	:	720-877-5881
Fax Number	:

Provider Business Practice Location Address
First Line	:	7474 E ARKANSAS AVE APT 2408
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2544
Country	:	US
Telephone Number	:	720-877-5881
Fax Number	:

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

Provider Enumeration Date	:	12/04/2015
Last Update Date	:	12/04/2015

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Directions to “ TELAL ABDELLATIF ” Practice Location

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