1942531827 NPI number — MISS MARGARET ROSE-ANDRIA GRANZELLA L.M.T

Table of content: MISS MARGARET ROSE-ANDRIA GRANZELLA L.M.T (NPI 1942531827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942531827 NPI number — MISS MARGARET ROSE-ANDRIA GRANZELLA L.M.T

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRANZELLA
Provider First Name:
MARGARET
Provider Middle Name:
ROSE-ANDRIA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
L.M.T
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942531827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEEKER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81641-1207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-942-9709
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
594 MAIN ST.
Provider Second Line Business Practice Location Address:
STE. 25
Provider Business Practice Location Address City Name:
MEEKER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-942-9709
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  15321 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225700000X , with the licence number: 0015124 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)