Provider Demographics
NPI:1902364987
Name:KURJAK, EMIR
Entity Type:Individual
Prefix:
First Name:EMIR
Middle Name:
Last Name:KURJAK
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 1:918 TIMBER CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-3936
Mailing Address - Country:US
Mailing Address - Phone:941-320-6169
Mailing Address - Fax:
Practice Address - Street 1:918 TIMBER CT
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-3936
Practice Address - Country:US
Practice Address - Phone:941-320-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant