Provider Demographics
NPI:1508168493
Name:TONY L ROBUCCI M D A PROFESSIONAL LLC
Entity Type:Organization
Organization Name:TONY L ROBUCCI M D A PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROBUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-861-1618
Mailing Address - Street 1:180 ADAMS ST
Mailing Address - Street 2:SUITE #250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5223
Mailing Address - Country:US
Mailing Address - Phone:303-861-1618
Mailing Address - Fax:303-863-1913
Practice Address - Street 1:180 ADAMS ST
Practice Address - Street 2:SUITE #250
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5223
Practice Address - Country:US
Practice Address - Phone:303-861-1618
Practice Address - Fax:303-863-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-26
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO331152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty