Healthcare Provider Details

I. General information

NPI: 1003991480
Provider Name (Legal Business Name): JEAN BIEN-AIME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-98 MANHATTAN AVENUE CABS HEALTH CENTER
BROOKLYN NY
11206
US

IV. Provider business mailing address

60 MADISON AVE 5TH FLOOR
NEW YORK NY
10010-1600
US

V. Phone/Fax

Practice location:
  • Phone: 718-388-0390
  • Fax: 718-486-5741
Mailing address:
  • Phone: 212-545-2400
  • Fax: 646-312-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number194308
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: