Provider Demographics
NPI:1124313671
Name:KULIFAJ, STEVE A (CO)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:A
Last Name:KULIFAJ
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 MATLEY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2100
Mailing Address - Country:US
Mailing Address - Phone:831-444-5889
Mailing Address - Fax:
Practice Address - Street 1:961 MATLEY LN STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2100
Practice Address - Country:US
Practice Address - Phone:831-444-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist