Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | DR.0066233 | CO |
Y | 207RH0002X | Hospice and Palliative Medicine | DR.0066233 | CO |
NPI | 1154776078 |
---|---|
Provider Name | Mary Gay Josephine Cruz Marangola |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 22/09/2021 |