Provider Demographics
NPI:1497085377
Name:PRECISE SURGICAL OF DENVER LLC
Entity Type:Organization
Organization Name:PRECISE SURGICAL OF DENVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SA-C
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-201-3690
Mailing Address - Street 1:1940 S LANSING CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1056
Mailing Address - Country:US
Mailing Address - Phone:720-201-3690
Mailing Address - Fax:
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1235
Practice Address - Country:US
Practice Address - Phone:303-839-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
CO09264273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
No273Y00000XHospital UnitsRehabilitation UnitGroup - Single Specialty