Provider Demographics
NPI:1083276109
Name:ABBASOVA, FADILYA
Entity Type:Individual
Prefix:
First Name:FADILYA
Middle Name:
Last Name:ABBASOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 S DUQUESNE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1319
Mailing Address - Country:US
Mailing Address - Phone:720-400-4261
Mailing Address - Fax:303-955-0791
Practice Address - Street 1:7575 S DUQUESNE WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1319
Practice Address - Country:US
Practice Address - Phone:720-400-4261
Practice Address - Fax:303-955-0791
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker