Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 19694 | CO |
NPI | 1013036714 |
---|---|
Provider Name | Dr. Leslie W Reitman |
First Address | Aurora, CO 80014-1622 |
Second Address | Aurora, CO 80014-1622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 06/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01196948 | (05) | CO |
018266 | KAISER COMMERCIAL NUMBER (01) | CO |