Individual
DR. STACEY LYNN MARTINIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
125051592
IL
2080P0214X
Pediatric Pulmonology Physician
Primary
47750
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35682388
—
CO
Enumeration date
07/29/2008
Last updated
06/20/2013
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