Provider Demographics
NPI:1821125600
Name:ASCARELLI, MARIAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:H
Last Name:ASCARELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIAN
Other - Middle Name:H
Other - Last Name:ASCARELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1400 E BOULDER ST
Mailing Address - Street 2:MEMORIAL HOSPITAL
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5533
Mailing Address - Country:US
Mailing Address - Phone:719-365-5960
Mailing Address - Fax:719-365-5977
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:MEMORIAL HOSPITAL
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-5960
Practice Address - Fax:719-365-5977
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37230174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist