Provider Demographics
NPI:1063689966
Name:TULANE SCHOOL DEPARTMENT OF PSYCHIATRY
Entity Type:Organization
Organization Name:TULANE SCHOOL DEPARTMENT OF PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC. PROF. OF CLINICAL PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:O' NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-988-4272
Mailing Address - Street 1:1440 CANAL ST
Mailing Address - Street 2:TB-53
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2703
Mailing Address - Country:US
Mailing Address - Phone:504-988-4272
Mailing Address - Fax:
Practice Address - Street 1:1440 CANAL ST
Practice Address - Street 2:TB-53
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2703
Practice Address - Country:US
Practice Address - Phone:504-988-4272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TULANE UNIVERSITY SCHOOL OF MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-11
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAGETP.TUL.P282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1022900Medicaid