Basic Information
| Provider Information | |||||||||
| NPI: | 1184662108 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CYRAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD, MSPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1960 OGDEN ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802183666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033181540 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Practice Location | |||||||||
| Address1: | 1960 OGDEN ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802183666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033181540 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 02/18/2013 | ||||||||
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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 | 207R00000X | 35423 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 35423 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 01354232 | 05 | CO | MEDICAID | P00264857 | 01 | MEDICARE RAILROAD | OTHER |