Provider Demographics
NPI:1184944431
Name:SUSINA, YULIYA
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:SUSINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 S MACON CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1825
Mailing Address - Country:US
Mailing Address - Phone:720-276-1705
Mailing Address - Fax:
Practice Address - Street 1:2677 S MACON CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1825
Practice Address - Country:US
Practice Address - Phone:720-276-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO732071376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide