Provider Demographics
NPI:1972595932
Name:YAMPOLSKY, NATALIE (OD)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:YAMPOLSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16253 E BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4157
Mailing Address - Country:US
Mailing Address - Phone:303-250-2765
Mailing Address - Fax:303-627-2702
Practice Address - Street 1:6101 S AURORA PKWY
Practice Address - Street 2:NEXT TO WAL-MART VISION CENTER
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5801
Practice Address - Country:US
Practice Address - Phone:303-617-7905
Practice Address - Fax:303-627-2702
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99177799152W00000X
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11219708OtherCAQH PROVIDER ID
CO11219708OtherCAQH PROVIDER ID
CO42983Medicare ID - Type Unspecified