Desamito, Marlene Gabriel

Desamito, Marlene Gabriel is an individual health care provider with primary practice located at 3311 Toledo Ter Suite C105, Hyattsville MD 20782-4135. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Desamito, Marlene Gabriel can be contacted via phone (301) 559-3323.

Contact Information

Primary practice address
3311 Toledo Ter Suite C105 Hyattsville MD 20782-4135
Phone: (301) 559-3323
Fax: (301) 599-3325
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0053700 Maryland

Profile Details

NPI number 1760566996
LBN Legal business name Desamito, Marlene Gabriel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Jun 20th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760566996 NPPES
Maryland Other 7221153 AETNA PROV. NO.
Maryland Other 1203744 AETNA PROV. NO.
Maryland MEDICAID 1356020 00 AETNA PROV. NO.
Maryland Other 94909 AETNA PROV. NO.

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