Basic Information
Provider Information
NPI: 1023514346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RATNASINGAM
FirstName: DENESH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12631 EAST 17TH AVE
Address2: MAIL STOP F493, AO1, RM 1201E
City: AURORA
State: CO
PostalCode: 800452527
CountryCode: US
TelephoneNumber: 3037247408
FaxNumber:  
Practice Location
Address1: 12631 EAST 17TH AVENUE
Address2: MAIL STOP F493, AO1, RM 1201E
City: AURORA
State: CO
PostalCode: 80045
CountryCode: US
TelephoneNumber: 3037247408
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2018
LastUpdateDate: 06/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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