Provider Demographics
NPI:1407446321
Name:ANNEST, SYNN, NOWAK AND MUBARAK, PROF LLC
Entity Type:Organization
Organization Name:ANNEST, SYNN, NOWAK AND MUBARAK, PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-880-7839
Mailing Address - Street 1:4105 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3620
Mailing Address - Country:US
Mailing Address - Phone:303-539-0736
Mailing Address - Fax:303-539-0737
Practice Address - Street 1:4105 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3620
Practice Address - Country:US
Practice Address - Phone:303-539-0736
Practice Address - Fax:303-539-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty