Provider Demographics
NPI:1497938799
Name:PAUL E CUTARELLI MD PROFESSIONAL LLC
Entity Type:Organization
Organization Name:PAUL E CUTARELLI MD PROFESSIONAL LLC
Other - Org Name:CUTARELLI VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EZIO
Authorized Official - Last Name:CUTARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-486-2020
Mailing Address - Street 1:7887 E BELLEVIEW AVE
Mailing Address - Street 2:#180
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6015
Mailing Address - Country:US
Mailing Address - Phone:303-486-2020
Mailing Address - Fax:303-221-3434
Practice Address - Street 1:7887 E BELLEVIEW AVE
Practice Address - Street 2:#180
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6015
Practice Address - Country:US
Practice Address - Phone:303-486-2020
Practice Address - Fax:303-221-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38485207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89901053Medicaid
G09166Medicare UPIN
CO89901053Medicaid