Provider Demographics
NPI:1427765122
Name:AYELE, ROMAN A (PHD)
Entity type:Individual
Prefix:
First Name:ROMAN
Middle Name:A
Last Name:AYELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 S PARKER RD STE 147
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2743
Mailing Address - Country:US
Mailing Address - Phone:720-862-6979
Mailing Address - Fax:
Practice Address - Street 1:2821 S PARKER RD STE 147
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2743
Practice Address - Country:US
Practice Address - Phone:720-862-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health