Provider Demographics
NPI:1265558571
Name:ESSENGUE BELIBI, SUZANNE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:ESSENGUE BELIBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 S VAUGHN WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3505
Mailing Address - Country:US
Mailing Address - Phone:303-755-4600
Mailing Address - Fax:303-745-3884
Practice Address - Street 1:3191 S VAUGHN WAY STE 101
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3505
Practice Address - Country:US
Practice Address - Phone:303-755-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46240207RA0201X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87872269Medicaid