Provider Demographics
NPI:1760494199
Name:MARICAR G. BELICENA, LTD
Entity Type:Organization
Organization Name:MARICAR G. BELICENA, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARICAR
Authorized Official - Middle Name:GABORNE
Authorized Official - Last Name:BELICENA-BADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-475-1504
Mailing Address - Street 1:PO BOX 7079
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19714-7079
Mailing Address - Country:US
Mailing Address - Phone:302-475-1504
Mailing Address - Fax:302-475-2345
Practice Address - Street 1:2500 GRUBB RD
Practice Address - Street 2:SUITE 120
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4799
Practice Address - Country:US
Practice Address - Phone:302-475-1504
Practice Address - Fax:302-475-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006184207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000002084Medicaid
DEG01870Medicare PIN