Basic Information
Provider Information
NPI: 1881608743
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CASUGA-MARQUEZ
FirstName: ERLINDA
MiddleName: RAMOS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 160
Address2:  
City: SHIPROCK
State: NM
PostalCode: 87420
CountryCode: US
TelephoneNumber: 5053686401
FaxNumber: 5053686431
Practice Location
Address1: US HWY 491 NORTH
Address2:  
City: SHIPROCK
State: NM
PostalCode: 87420
CountryCode: US
TelephoneNumber: 5053686401
FaxNumber: 5053686431
Other Information
ProviderEnumerationDate: 07/28/2006
LastUpdateDate: 01/04/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X38718NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

ID Information
IDTypeStateIssuerDescription
09712305AZ MEDICAID
8032756705CO MEDICAID
9722628905NM MEDICAID


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