Healthcare Provider Details

I. General information

NPI: 1235915844
Provider Name (Legal Business Name): MARIAH ELISA DELGADO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26367 CONIFER RD STE A
CONIFER CO
80433-9137
US

IV. Provider business mailing address

10 KENNEDY DR
LOS LUNAS NM
87031-7613
US

V. Phone/Fax

Practice location:
  • Phone: 303-838-3900
  • Fax:
Mailing address:
  • Phone: 520-678-3289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019332
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: