Provider Demographics
NPI:1518025634
Name:COLORADO CHILDRENS EAR NOSE & THROAT PC
Entity Type:Organization
Organization Name:COLORADO CHILDRENS EAR NOSE & THROAT PC
Other - Org Name:SHARON M TOMASKI MD COLORADO ADULT CHILDRENS EAR NOSE & THROAT PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA, CMPE, CPC
Authorized Official - Phone:303-347-0800
Mailing Address - Street 1:7720 S BROADWAY
Mailing Address - Street 2:SUITE 480
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122
Mailing Address - Country:US
Mailing Address - Phone:303-347-0800
Mailing Address - Fax:303-347-1140
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:SUITE 480
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-347-0800
Practice Address - Fax:303-347-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85882046Medicaid
COC476488Medicare PIN
CO85882046Medicaid