Provider Demographics
NPI:1598367955
Name:COLORADO HEART AND VASCULAR PC
Entity Type:Organization
Organization Name:COLORADO HEART AND VASCULAR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIETRZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-595-2727
Mailing Address - Street 1:11700 W 2ND PL STE 350
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1710
Mailing Address - Country:US
Mailing Address - Phone:303-595-2727
Mailing Address - Fax:
Practice Address - Street 1:2030 MOUNTAIN VIEW AVE STE 220
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3180
Practice Address - Country:US
Practice Address - Phone:303-515-4651
Practice Address - Fax:303-772-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty