Provider Demographics
NPI:1164483608
Name:BINICK, MARLENE DIANE (NP)
Entity Type:Individual
Prefix:MISS
First Name:MARLENE
Middle Name:DIANE
Last Name:BINICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:MARLENE
Other - Middle Name:DIANE
Other - Last Name:SIEMEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5 RED BUD CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3262
Mailing Address - Country:US
Mailing Address - Phone:410-686-2663
Mailing Address - Fax:
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7919
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO56389363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health