Provider Demographics
NPI:1538264916
Name:ORSINI, EDMUND N JR (MD)
Entity type:Individual
Prefix:
First Name:EDMUND
Middle Name:N
Last Name:ORSINI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1556
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201
Mailing Address - Country:US
Mailing Address - Phone:303-869-3182
Mailing Address - Fax:
Practice Address - Street 1:1056 EAST 19TH AVE
Practice Address - Street 2:PATHOLOGY B120
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1007
Practice Address - Country:US
Practice Address - Phone:303-861-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR16641207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01166412Medicaid
CO01166412Medicaid