Provider Demographics
NPI:1366859829
Name:SIGEL, IRENA (OD)
Entity Type:Individual
Prefix:
First Name:IRENA
Middle Name:
Last Name:SIGEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BRIGHTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-5019
Mailing Address - Country:US
Mailing Address - Phone:504-250-6705
Mailing Address - Fax:
Practice Address - Street 1:3545 QUEBEC ST
Practice Address - Street 2:SUITE 115
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1603
Practice Address - Country:US
Practice Address - Phone:303-501-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003074152W00000X
TX8407T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist