Provider Demographics
NPI:1326194929
Name:MASCOLO, MARGHERITA (MD)
Entity Type:Individual
Prefix:
First Name:MARGHERITA
Middle Name:
Last Name:MASCOLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:DENVER HEALTH AND HOSPITAL AUTHORITY
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204
Mailing Address - Country:US
Mailing Address - Phone:303-436-6900
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:DENVER HEALTH & HOSPITAL AUTHORITY
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-0000
Practice Address - Country:US
Practice Address - Phone:303-436-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46767207R00000X
COTL-1593390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program