Provider Demographics
NPI:1558196980
Name:BINIECKI, TANIA HORICAN (NP)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:HORICAN
Last Name:BINIECKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 ALBURG SPGS RD
Mailing Address - Street 2:
Mailing Address - City:ALBURGH
Mailing Address - State:VT
Mailing Address - Zip Code:05440-4129
Mailing Address - Country:US
Mailing Address - Phone:802-363-5913
Mailing Address - Fax:
Practice Address - Street 1:802 ALBURGH SPGS RD
Practice Address - Street 2:
Practice Address - City:ALBURGH
Practice Address - State:VT
Practice Address - Zip Code:05440
Practice Address - Country:US
Practice Address - Phone:802-363-5913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0137353363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health