Provider Demographics
NPI:1104001791
Name:BINNING, MANDY JO (MD)
Entity Type:Individual
Prefix:DR
First Name:MANDY
Middle Name:JO
Last Name:BINNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 MEDICAL CENTER BLVD STE 232
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:844-464-6387
Mailing Address - Fax:215-239-3037
Practice Address - Street 1:3100 PRINCETON PIKE BLDG 3
Practice Address - Street 2:SUITE D
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:844-464-6387
Practice Address - Fax:215-239-3037
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD447260207T00000X
NJ25MA08889300207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028486900001Medicaid
NJ0264270Medicaid
PA1028486900001Medicaid
NJ220631YHDMMedicare PIN
NJ0264270Medicaid
NJ220631ZLRPMedicare PIN