Provider Demographics
NPI:1407138787
Name:FISHEROWITZ, JANA S (PT)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:S
Last Name:FISHEROWITZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5406
Mailing Address - Country:US
Mailing Address - Phone:303-750-8418
Mailing Address - Fax:303-750-0021
Practice Address - Street 1:1600 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5406
Practice Address - Country:US
Practice Address - Phone:303-750-8418
Practice Address - Fax:303-750-0021
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8264174400000X
MO00929174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist