Provider Demographics
NPI:1588459259
Name:KANSAL, ABHISHEKH SONU (MDM)
Entity type:Individual
Prefix:
First Name:ABHISHEKH
Middle Name:SONU
Last Name:KANSAL
Suffix:
Gender:
Credentials:MDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 EMPORIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2909
Mailing Address - Country:US
Mailing Address - Phone:720-202-4990
Mailing Address - Fax:
Practice Address - Street 1:2975 EMPORIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2909
Practice Address - Country:US
Practice Address - Phone:720-202-4990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered
No172A00000XOther Service ProvidersDriver
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program