Provider Demographics
NPI:1750963567
Name:CSEAK, RICHARD W JR
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:CSEAK
Suffix:JR
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 1:2480 S DOWNING ST STE 204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5881
Mailing Address - Country:US
Mailing Address - Phone:303-777-7870
Mailing Address - Fax:303-777-7889
Practice Address - Street 1:2480 S DOWNING ST STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5881
Practice Address - Country:US
Practice Address - Phone:303-777-7870
Practice Address - Fax:303-777-7889
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04M281253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04M281OtherIN-HOME SUPPORTIVE CARE