Provider Demographics
NPI:1932161437
Name:ROKOSZ, LAURA A (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:ROKOSZ
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 1:7114 W JEFFERSON AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2356
Mailing Address - Country:US
Mailing Address - Phone:303-531-4660
Mailing Address - Fax:303-531-4659
Practice Address - Street 1:7114 W JEFFERSON AVE
Practice Address - Street 2:STE 205
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2356
Practice Address - Country:US
Practice Address - Phone:303-531-4660
Practice Address - Fax:303-531-4659
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33819174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG25590Medicare UPIN
804075Medicare ID - Type Unspecified