| Geropsych, Pc | |
|
1601 Constitution Rd Pueblo CO 81001-2197 | |
| (719) 562-7200 | |
| Not Available |
| Full Name | Geropsych, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1601 Constitution Rd, Pueblo, Colorado |
| Authorized Official Name and Position | David Anthony Scola (PROVIDER) |
| Authorized Official Contact | 7196494644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geropsych, Pc 1220 S Liberty Point Blvd Pueblo West CO 81007-7513 Ph: (719) 649-4644 | Geropsych, Pc 1601 Constitution Rd Pueblo CO 81001-2197 Ph: (719) 562-7200 |
| NPI Number | 1154561025 |
|---|---|
| Provider Enumeration Date | 03/04/2009 |
| Last Update Date | 10/06/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 6901954767 |
|---|---|
| Medicare Enrollment ID | O20090505000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154561025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | David Anthony Scola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144318064 PECOS PAC ID: 3577645886 Enrollment ID: I20080125000196 |
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