Provider Demographics
NPI:1609927672
Name:COVAK, ALISON (PA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:COVAK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:STE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-584-8000
Mailing Address - Fax:303-584-8141
Practice Address - Street 1:2055 HIGH STREET
Practice Address - Street 2:STE 370
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5504
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1529363A00000X, 208000000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY134140500Medicaid
CO63137062Medicaid
NE1025570000Medicaid