Provider Demographics
NPI:1801391180
Name:AIME-MARCELIN, KEREN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEREN
Middle Name:
Last Name:AIME-MARCELIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KEREN
Other - Middle Name:
Other - Last Name:MARCELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4740 S I 10 SERVICE RD W STE 120
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1214
Mailing Address - Country:US
Mailing Address - Phone:504-988-5458
Mailing Address - Fax:
Practice Address - Street 1:4740 S I 10 SERVICE RD W STE 120
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-988-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA309688208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics