1225084411 NPI number — MICHEL BIEN-AIME MD

Table of content: MICHEL BIEN-AIME MD (NPI 1225084411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225084411 NPI number — MICHEL BIEN-AIME MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIEN-AIME
Provider First Name:
MICHEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225084411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 S 31ST ST
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
PHILA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19146-3506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-925-2400
Provider Business Mailing Address Fax Number:
215-925-9162

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 S 4TH ST
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
PHILA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19147-5948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-339-1079
Provider Business Practice Location Address Fax Number:
215-952-6966
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  MD050148 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001542085 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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