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Individual

DR. LIA R MATARRESE MCGIBBON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1910 COALTON RD, SUPERIOR, CO 80027-4674
(720) 494-4700
(720) 494-4706
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
279671
NY
207RR0500X
Rheumatology Physician
Primary
50866
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
70976287
CO
Enumeration date
04/30/2009
Last updated
04/14/2026
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