Basic Information
| Provider Information | |||||||||
| NPI: | 1801391180 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AIME-MARCELIN | ||||||||
| FirstName: | KEREN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARCELIN | ||||||||
| OtherFirstName: | KEREN | ||||||||
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| OtherCredential: | M.D | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4740 S I 10 SERVICE RD W STE 120 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700011214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049885458 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4740 S I 10 SERVICE RD W STE 120 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049885458 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2018 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 309688 | LA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.