Provider Demographics
NPI:1841371796
Name:GADAYEV, YURY (PA - C)
Entity type:Individual
Prefix:
First Name:YURY
Middle Name:
Last Name:GADAYEV
Suffix:
Gender:M
Credentials:PA - C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13111 E BRIARWOOD AVE
Mailing Address - Street 2:#200
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3930
Mailing Address - Country:US
Mailing Address - Phone:303-493-1922
Mailing Address - Fax:303-493-1926
Practice Address - Street 1:13111 E BRIARWOOD AVE
Practice Address - Street 2:200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3930
Practice Address - Country:US
Practice Address - Phone:303-493-1922
Practice Address - Fax:303-493-1926
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2323363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant