Provider Demographics
NPI:1760688543
Name:VOSKOVYKH, SERGEY
Entity Type:Individual
Prefix:MR
First Name:SERGEY
Middle Name:
Last Name:VOSKOVYKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12083 E HARVARD AVE # 1-204
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-7636
Mailing Address - Country:US
Mailing Address - Phone:720-427-1874
Mailing Address - Fax:
Practice Address - Street 1:12083 E HARVARD AVE # 1-204
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-7636
Practice Address - Country:US
Practice Address - Phone:720-427-1874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76876527Medicaid