Provider Demographics
NPI:1891320149
Name:KASA, DEJENE A
Entity Type:Individual
Prefix:
First Name:DEJENE
Middle Name:A
Last Name:KASA
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 1:19602 E GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5829
Mailing Address - Country:US
Mailing Address - Phone:303-335-7064
Mailing Address - Fax:
Practice Address - Street 1:19602 E GARDEN DR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5829
Practice Address - Country:US
Practice Address - Phone:303-335-7064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)