Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 58725 | CO |
N | 207YS0123X | Facial Plastic Surgeon | 5101019122 | MI |
NPI | 1891082491 |
---|---|
Provider Name | Dr. John Nikolay Bangiyev |
First Address | Denver, CO 80205-5504 |
Second Address | Denver, CO 80205-5504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 26/02/2019 |