Provider Demographics
NPI:1124023700
Name:NEW ORLEANS HEADACHE & NEUROLOGY CLINIC, APMC
Entity Type:Organization
Organization Name:NEW ORLEANS HEADACHE & NEUROLOGY CLINIC, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DHANPAT
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOHNOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-391-7547
Mailing Address - Street 1:120 MEADOWCREST ST
Mailing Address - Street 2:STE 420
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5255
Mailing Address - Country:US
Mailing Address - Phone:504-391-7547
Mailing Address - Fax:504-391-7549
Practice Address - Street 1:120 MEADOWCREST ST
Practice Address - Street 2:STE 420
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5255
Practice Address - Country:US
Practice Address - Phone:504-391-7547
Practice Address - Fax:504-391-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05061R2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1797766Medicaid
LA56817Medicare PIN
LACP7408Medicare PIN