Healthcare Provider Details

I. General information

NPI: 1164590865
Provider Name (Legal Business Name): LUCINDA ELDER BIEN-AIME M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 KANE PL NE
WASHINGTON DC
20019-3969
US

IV. Provider business mailing address

4604 KANE PL NE
WASHINGTON DC
20019-3969
US

V. Phone/Fax

Practice location:
  • Phone: 202-294-1230
  • Fax:
Mailing address:
  • Phone: 202-294-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0065007
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD036301
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: