Provider Demographics
NPI:1376117564
Name:BIEN-AIME, MARGANICK
Entity type:Individual
Prefix:
First Name:MARGANICK
Middle Name:
Last Name:BIEN-AIME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E EVERGREEN ROAD
Mailing Address - Street 2:SUITE 101, PMB 1054
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 E EVERGREEN ROAD
Practice Address - Street 2:SUITE 101, PMB 1054
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5146
Practice Address - Country:US
Practice Address - Phone:917-633-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028967363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant