Healthcare Provider Details

I. General information

NPI: 1396277182
Provider Name (Legal Business Name): MARINA MOSKALENKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 ORCHARD PKWY
WESTMINSTER CO
80023-9206
US

IV. Provider business mailing address

4565 N RALEIGH ST
DENVER CO
80212-2537
US

V. Phone/Fax

Practice location:
  • Phone: 720-627-4840
  • Fax: 720-627-4841
Mailing address:
  • Phone: 347-423-4562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberDR.0068490
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: