1881853513 NPI number — DR. ELLEN JONES MANGIONE MD, MPH

Table of content: DR. ELLEN JONES MANGIONE MD, MPH (NPI 1881853513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881853513 NPI number — DR. ELLEN JONES MANGIONE MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANGIONE
Provider First Name:
ELLEN
Provider Middle Name:
JONES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
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:
1881853513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1055 CLERMONT ST
Provider Second Line Business Mailing Address:
COS OFFICE, BOX 11
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80220-3808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-393-2820
Provider Business Mailing Address Fax Number:
303-393-2861

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1055 CLERMONT ST
Provider Second Line Business Practice Location Address:
COS OFFICE, BOX 11
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80220-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-393-2820
Provider Business Practice Location Address Fax Number:
303-393-2861
Provider Enumeration Date:
06/06/2008

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: 207RI0200X , with the licence number:  28093 , 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)





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