Healthcare Provider Details

I. General information

NPI: 1801391180
Provider Name (Legal Business Name): KEREN AIME-MARCELIN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEREN MARCELIN M.D

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 CLARKSON AVE
BROOKLYN NY
11203-2012
US

IV. Provider business mailing address

155 WASHINGTON STREET 222
NEWARK NJ
07102
US

V. Phone/Fax

Practice location:
  • Phone: 718-270-4714
  • Fax: 718-270-1985
Mailing address:
  • Phone: 504-988-5458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number337361
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: