Provider Demographics
NPI:1639125776
Name:MARLINO, TERESA A (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:A
Last Name:MARLINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:255 W LANCASTER AVE
Mailing Address - Street 2:SUITE 222 PAOLI MEDICAL BUILDING II
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1763
Mailing Address - Country:US
Mailing Address - Phone:610-647-5111
Mailing Address - Fax:610-647-5113
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:SUITE 222 PAOLI MEDICAL BUILDING II
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1763
Practice Address - Country:US
Practice Address - Phone:610-647-5111
Practice Address - Fax:610-647-5113
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD067271-L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA079762300OtherINDEPENDENCE BLUE CROSS
PA7370091OtherAETNA
PAMA113562OtherHIGHMARK BLUE SHIELD
PAH28482Medicare UPIN
PA079762300OtherINDEPENDENCE BLUE CROSS