Provider Demographics
NPI:1144360686
Name:VANANROOY, SARA (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:VANANROOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 S PERRY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1958
Mailing Address - Country:US
Mailing Address - Phone:303-663-0360
Mailing Address - Fax:303-663-5512
Practice Address - Street 1:1189 S PERRY ST STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1958
Practice Address - Country:US
Practice Address - Phone:303-663-0360
Practice Address - Fax:303-663-5512
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO286212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92011Medicare ID - Type Unspecified
COE58988Medicare UPIN