Provider Demographics
NPI:1386056257
Name:EHRENREICH-PIOT, KALINA (DO)
Entity type:Individual
Prefix:
First Name:KALINA
Middle Name:
Last Name:EHRENREICH-PIOT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1745
Mailing Address - Country:US
Mailing Address - Phone:303-697-2583
Mailing Address - Fax:720-322-9411
Practice Address - Street 1:1115 2ND ST
Practice Address - Street 2:
Practice Address - City:FORT LUPTON
Practice Address - State:CO
Practice Address - Zip Code:80621-1745
Practice Address - Country:US
Practice Address - Phone:303-697-2583
Practice Address - Fax:720-322-9411
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COR2396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine