Basic Information
| Provider Information | |||||||||
| NPI: | 1073180865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCBAIN | ||||||||
| FirstName: | LEXIAN | ||||||||
| MiddleName: | JEANEL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 SELWYN AVENUE | ||||||||
| Address2: | SUITE 6D | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189601416 | ||||||||
| FaxNumber: | 7185185124 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 SELWYN AVENUE | ||||||||
| Address2: | SUITE 6D | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189601416 | ||||||||
| FaxNumber: | 7185185124 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2021 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.