Provider Demographics
NPI:1942744198
Name:D AMPEZZO NEUROLOGICA
Entity Type:Organization
Organization Name:D AMPEZZO NEUROLOGICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TECHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-315-4018
Mailing Address - Street 1:7207 STREAMSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8816
Mailing Address - Country:US
Mailing Address - Phone:970-315-4018
Mailing Address - Fax:970-315-5554
Practice Address - Street 1:7207 STREAMSIDE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-8816
Practice Address - Country:US
Practice Address - Phone:970-315-4018
Practice Address - Fax:970-315-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty