Provider Demographics
NPI:1093919235
Name:KOCOL, KATARZYNA ZOFIA (DO)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:ZOFIA
Last Name:KOCOL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911244
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1244
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6640
Practice Address - Street 1:4350 LIMELIGHT AVE STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8034
Practice Address - Country:US
Practice Address - Phone:720-455-3775
Practice Address - Fax:720-455-3776
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16272081P2900X
CODR.00568582081N0008X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68910541Medicaid
SC016271Medicaid
SCP01110442OtherRAILROAD MEDICARE
SCP01110442OtherRAILROAD MEDICARE