Provider Demographics
NPI:1760519714
Name:REZNICKOVA, NORA A (MD)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:A
Last Name:REZNICKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:A
Other - Last Name:KABATOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 S PARKER RD
Practice Address - Street 2:SUITE 400
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1622
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38643207R00000X
CODR.0038643207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
011932OtherKAISER-COMMERCIAL NUMBER
CO83404775Medicaid
COCK11036Medicare PIN
COH36022Medicare UPIN