Provider Demographics
NPI:1023241684
Name:ALSIS, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ALSIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 W JEWELL AVE
Mailing Address - Street 2:9-104
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6237
Mailing Address - Country:US
Mailing Address - Phone:617-308-3518
Mailing Address - Fax:
Practice Address - Street 1:5201 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2061
Practice Address - Country:US
Practice Address - Phone:303-293-8554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator