Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2017-01121 | NC |
Y | 2080P0204X | Pediatric Emergency Doctor | DR.0063877 | CO |
NPI | 1134566003 |
---|---|
Provider Name | Ashley Elisabeth Mazo |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 21/08/2020 |