Basic Information
| Provider Information | |||||||||
| NPI: | 1457572695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARIKH | ||||||||
| FirstName: | MANSI | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 DRY CREEK DR | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805036499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037723300 | ||||||||
| FaxNumber: | 3036823380 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 DRY CREEK DR | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805036499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037723300 | ||||||||
| FaxNumber: | 3036823380 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 125-050274 | IL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 37734 | IA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | MD 60096106 | WA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 71862 | OR | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0009X | DR.0061896 | CO | Y |
No ID Information.