Healthcare Provider Details

I. General information

NPI: 1003188939
Provider Name (Legal Business Name): REINE KAMTCHEU LIENOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW SUITE 323
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

7229 HANOVER PKWY STE A
GREENBELT MD
20770-2026
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-3060
  • Fax: 202-723-3065
Mailing address:
  • Phone: 301-345-1124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25721
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: