Healthcare Provider Details

I. General information

NPI: 1194659748
Provider Name (Legal Business Name): LILIANE V PAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10512 SUNNY BROOKE LN
POTOMAC MD
20854-6391
US

IV. Provider business mailing address

10512 SUNNY BROOKE LN
POTOMAC MD
20854-6391
US

V. Phone/Fax

Practice location:
  • Phone: 202-590-0873
  • Fax:
Mailing address:
  • Phone: 202-590-0873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number204250
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: