Provider Demographics
NPI:1821562596
Name:LIVERANT, SHAY
Entity Type:Individual
Prefix:
First Name:SHAY
Middle Name:
Last Name:LIVERANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 BENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7868
Mailing Address - Country:US
Mailing Address - Phone:720-621-2167
Mailing Address - Fax:
Practice Address - Street 1:10275 BENTWOOD CT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7868
Practice Address - Country:US
Practice Address - Phone:720-621-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist