=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518311513
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BINNUR GENC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2016
-----------------------------------------------------
Last Update Date | 10/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6510 KENILWORTH AVE STE 2500
-----------------------------------------------------
City | RIVERDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20737-1346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-997-1907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6510 KENILWORTH AVE STE 2500
-----------------------------------------------------
City | RIVERDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20737-1346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-997-1907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F0416015
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------