Provider Demographics
NPI:1538110531
Name:MIRALDI, JUSTINE MARIE (CST/SA-C)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:MARIE
Last Name:MIRALDI
Suffix:
Gender:F
Credentials:CST/SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6075
Mailing Address - Country:US
Mailing Address - Phone:303-596-5774
Mailing Address - Fax:720-274-2828
Practice Address - Street 1:200 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6075
Practice Address - Country:US
Practice Address - Phone:303-596-5774
Practice Address - Fax:720-274-2828
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor