Provider Demographics
NPI:1417904236
Name:TRIPATHI, SANJAY P (MD)
Entity Type:Individual
Prefix:MR
First Name:SANJAY
Middle Name:P
Last Name:TRIPATHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E. HARVARD AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:303-778-6527
Mailing Address - Fax:303-733-1288
Practice Address - Street 1:950 E. HARVARD AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210
Practice Address - Country:US
Practice Address - Phone:303-778-6527
Practice Address - Fax:303-733-1288
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-32222208G00000X
CO54328208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
H26691Medicare UPIN