Provider Demographics
NPI:1740468024
Name:KOLONIC, ANDRIJANO (MS, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:ANDRIJANO
Middle Name:
Last Name:KOLONIC
Suffix:
Gender:M
Credentials:MS, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 SGT JON STILES DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2266
Mailing Address - Country:US
Mailing Address - Phone:303-274-7332
Mailing Address - Fax:720-497-6733
Practice Address - Street 1:1265 SGT JON STILES DR UNIT D
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2266
Practice Address - Country:US
Practice Address - Phone:303-274-7332
Practice Address - Fax:720-497-6733
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08-0040225X00000X
CO8025225X00000X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500651521Medicaid
CC882ZMedicare PIN
R165198Medicare PIN
ORR166904Medicare PIN