Provider Demographics
NPI:1891721908
Name:MARZICOLA, CAREY M (PA)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:M
Last Name:MARZICOLA
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7402 YORK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7532
Mailing Address - Country:US
Mailing Address - Phone:410-821-7471
Mailing Address - Fax:410-821-9582
Practice Address - Street 1:7601 OSLER DRIVE
Practice Address - Street 2:SAINT JOSEPH MEDICAL CENTER
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-337-1226
Practice Address - Fax:410-337-1118
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-12-30
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Provider Licenses
StateLicense IDTaxonomies
MDC00001813363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP27405Medicare UPIN