Individual
ABBY LISE BLEISTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2600 CAMPUS DR, SUITE A, LAFAYETTE, CO 80026-3357
(303) 673-1900
(303) 673-1915
Mailing address
500 ELDORADO BLVD STE 6250, BROOMFIELD, CO 80021-3421
(303) 272-0768
(303) 318-2488
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39420
CO
208000000X
Pediatrics Physician
39420
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43753311
—
CO
01
—
P00773004
MEDICARE RAILROAD
CO
Enumeration date
01/20/2006
Last updated
12/18/2013
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