Provider Demographics
NPI:1760038905
Name:GESSESE, ZAID YEMANE
Entity type:Individual
Prefix:
First Name:ZAID
Middle Name:YEMANE
Last Name:GESSESE
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 1:8841 E FLORIDA AVE APT A108
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2882
Mailing Address - Country:US
Mailing Address - Phone:720-285-9980
Mailing Address - Fax:
Practice Address - Street 1:8841 E FLORIDA AVE APT A108
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2882
Practice Address - Country:US
Practice Address - Phone:720-285-9980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO07-0860442172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver