Provider Demographics
NPI:1356505440
Name:SARA VAN ANROOY, M.D., P.C.
Entity Type:Organization
Organization Name:SARA VAN ANROOY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN ANROOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-663-0360
Mailing Address - Street 1:1189 S PERRY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1959
Mailing Address - Country:US
Mailing Address - Phone:303-663-0360
Mailing Address - Fax:303-663-5512
Practice Address - Street 1:1189 S PERRY ST
Practice Address - Street 2:STE 100
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1959
Practice Address - Country:US
Practice Address - Phone:303-663-0360
Practice Address - Fax:303-663-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28621174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE58988Medicare UPIN