Provider Demographics
NPI:1326057050
Name:TESTORI, ALESSANDRO (MD PHD)
Entity Type:Individual
Prefix:
First Name:ALESSANDRO
Middle Name:
Last Name:TESTORI
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 PROFESSIONAL LN UNIT 170
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6971
Mailing Address - Country:US
Mailing Address - Phone:303-776-0868
Mailing Address - Fax:303-776-0848
Practice Address - Street 1:1551 PROFESSIONAL LN UNIT 170
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6971
Practice Address - Country:US
Practice Address - Phone:303-776-0868
Practice Address - Fax:303-776-0848
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68533756Medicaid
IL036115332OtherSTATE LICENSE
CO48867OtherSTATE LICENSE