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General NPI Number Information
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NPI Number | 1427822212
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Entity Type | Organization
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Legal Business Name | ELDORADO PSYCHIATRY
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 1942 BROADWAY STE 314C
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City | BOULDER
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State | CO
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Zip | 80302-5233
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Country | US
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Telephone | 908-227-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 EISENHOWER DR APT P-313
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City | BOULDER
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State | CO
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Zip | 80303-8124
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Country | US
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Telephone | 908-227-1846
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | ANNA SHAPIRO
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Credential | MD
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Telephone | 908-227-1846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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