Basic Information
| Provider Information | |||||||||
| NPI: | 1144619735 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORONEY | ||||||||
| FirstName: | MARISA | ||||||||
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| Credential: | MD | ||||||||
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| OtherLastName: | PERI | ||||||||
| OtherFirstName: | MARISA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2103 W 32ND AVE | ||||||||
| Address2: | UNIT 4 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802113551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757413434 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12605 E 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800452545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037242052 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2015 | ||||||||
| LastUpdateDate: | 07/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | TL.0005489 | CO | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VX0201X | DR.0061891 | CO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
No ID Information.