Provider Demographics
NPI:1659782621
Name:DENIS A WAROBIEW OD PC
Entity Type:Organization
Organization Name:DENIS A WAROBIEW OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAROBIEW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-874-9540
Mailing Address - Street 1:531 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1817
Mailing Address - Country:US
Mailing Address - Phone:970-874-9540
Mailing Address - Fax:970-874-5082
Practice Address - Street 1:531 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1817
Practice Address - Country:US
Practice Address - Phone:970-874-9540
Practice Address - Fax:970-874-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty