Provider Demographics
NPI:1457040412
Name:BURUKIE, BIRUTAWIT ZELALEM (BB)
Entity Type:Individual
Prefix:
First Name:BIRUTAWIT
Middle Name:ZELALEM
Last Name:BURUKIE
Suffix:
Gender:F
Credentials:BB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 CENTRAL PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-4115
Mailing Address - Country:US
Mailing Address - Phone:720-329-5307
Mailing Address - Fax:
Practice Address - Street 1:2133 CENTRAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-4115
Practice Address - Country:US
Practice Address - Phone:720-329-5307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility