Healthcare Provider Details

I. General information

NPI: 1154508737
Provider Name (Legal Business Name): LUCIENNE A. CAHEN, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2008
Last Update Date: 01/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 CONCORD AVE
CAMBRIDGE MA
02138-1334
US

IV. Provider business mailing address

107 GARDEN ST
CAMBRIDGE MA
02138-6703
US

V. Phone/Fax

Practice location:
  • Phone: 671-868-3878
  • Fax: 617-868-3878
Mailing address:
  • Phone: 617-868-3878
  • Fax: 617-868-3878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCIENNE A CAHEN
Title or Position: OWNER
Credential: M.D.
Phone: 617-868-3878