Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD071985L | PA |
Y | 2080P0204X | Pediatric Emergency Doctor | DR.0052221 | CO |
N | 2080P0204X | Pediatric Emergency Doctor | MD071985L | PA |
NPI | 1134142177 |
---|---|
Provider Name | Rakesh D Mistry |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 12/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001855034 | (05) | PA |
8643407 | (05) | NJ |
H46280 | (02) |