Provider Demographics
NPI:1033280722
Name:LOUISANA PHYSICAL MEDICINE AND REHAB ASSOCIATES
Entity Type:Organization
Organization Name:LOUISANA PHYSICAL MEDICINE AND REHAB ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DROPADI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEWALRAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-899-3031
Mailing Address - Street 1:3301 ST CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-899-3031
Mailing Address - Fax:504-899-3052
Practice Address - Street 1:3301 ST CHARLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-899-3031
Practice Address - Fax:504-899-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1794040Medicaid
08486OtherBLUE CROSS
B64189Medicare UPIN
08486OtherBLUE CROSS
LA1794040Medicaid