Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125067619 | IL |
Y | 2080P0205X | Pediatric Endocrinologist | DR0060417 | CO |
NPI | 1417341074 |
---|---|
Provider Name | Amy Alexander Rydin |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2015 |
Last Update Date | 26/06/2018 |