Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 44085 | CO |
N | 207NP0225X | Pediatric Dermatologist | 44085 | CO |
N | 207NS0135X | Procedural Dermatology | 44085 | CO |
NPI | 1043242225 |
---|---|
Provider Name | Dr. Joshua Burkitte Dicarlo |
First Address | Denver, CO 80247-1314 |
Second Address | Centennial, CO 80122-2312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020943 | KAISER COMMERCIAL NUMBER (01) | CO |
98332864 | (05) | CO |
I15190 | (02) | CO |