Provider Demographics
NPI:1285450809
Name:LAKSHIN, NIKITA KONSTANTIN
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:KONSTANTIN
Last Name:LAKSHIN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 S OURAY ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-5135
Mailing Address - Country:US
Mailing Address - Phone:720-470-9941
Mailing Address - Fax:
Practice Address - Street 1:1777 S OURAY ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-5135
Practice Address - Country:US
Practice Address - Phone:720-470-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter