Provider Demographics
NPI:1194024083
Name:HERNANDEZ, LAUREN MALUS (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MALUS
Last Name:HERNANDEZ
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 1:1041 VETERANS MEMORIAL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2848
Mailing Address - Country:US
Mailing Address - Phone:504-267-9336
Mailing Address - Fax:504-267-9337
Practice Address - Street 1:1041 VETERANS MEMORIAL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2848
Practice Address - Country:US
Practice Address - Phone:504-267-9336
Practice Address - Fax:504-267-9337
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2150944Medicaid