Provider Demographics
NPI:1184824393
Name:AL-DUJAILI, ZEENA J (MD)
Entity Type:Individual
Prefix:
First Name:ZEENA
Middle Name:J
Last Name:AL-DUJAILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:#8036
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-1700
Mailing Address - Fax:504-988-1721
Practice Address - Street 1:1430 TULANE AVE
Practice Address - Street 2:#8036
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-1700
Practice Address - Fax:504-988-1721
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202380207ND0101X
NY202580207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1000523Medicaid