Provider Demographics
NPI:1124425640
Name:ROTBART, NURIT
Entity type:Individual
Prefix:
First Name:NURIT
Middle Name:
Last Name:ROTBART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NURIT
Other - Middle Name:
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8083 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6802
Mailing Address - Country:US
Mailing Address - Phone:303-888-7804
Mailing Address - Fax:
Practice Address - Street 1:1980 DAHLIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1239
Practice Address - Country:US
Practice Address - Phone:303-888-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090455104100000X
CO099262511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker