Provider Demographics
NPI:1063018190
Name:PEDIATRIC ENDOCRINE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PEDIATRIC ENDOCRINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-783-3883
Mailing Address - Street 1:8200 E BELLEVIEW AVE STE 510E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2808
Mailing Address - Country:US
Mailing Address - Phone:303-783-3883
Mailing Address - Fax:
Practice Address - Street 1:6965 TUTT BLVD STE 210
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3598
Practice Address - Country:US
Practice Address - Phone:303-783-3883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEDIATRIC ENDOCRINE ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-04
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty