Provider Demographics
NPI:1699842880
Name:LICHTENSTEIN, CARA (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:LICHTENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 OLD COLUMBIA PIKE- SILVER SPRING PEDIATRICS
Mailing Address - Street 2:STE 300
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12301 OLD COLUMBIA PIKE- SILVER SPRING PEDIATRICS
Practice Address - Street 2:STE 300
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-625-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33436208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I50092Medicare UPIN