Provider Demographics
NPI:1699913053
Name:PORTNUFF, CORY DAVID FARQUHAR (AUD, PHD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:DAVID FARQUHAR
Last Name:PORTNUFF
Suffix:
Gender:M
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1821
Mailing Address - Country:US
Mailing Address - Phone:720-848-7218
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT # 6200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO547231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist