Provider Demographics
NPI:1225304975
Name:NASSAU ADVANCED FOOT & ANKLE, A PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:NASSAU ADVANCED FOOT & ANKLE, A PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSAU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-758-9031
Mailing Address - Street 1:PO BOX 46254
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201-6254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3525 S TAMARAC DR
Practice Address - Street 2:#330
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1419
Practice Address - Country:US
Practice Address - Phone:303-758-9031
Practice Address - Fax:303-758-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO713213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty