Provider Demographics
NPI:1326197591
Name:BISWAS, MINATI D (MD)
Entity Type:Individual
Prefix:
First Name:MINATI
Middle Name:D
Last Name:BISWAS
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 1:230 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3932
Mailing Address - Country:US
Mailing Address - Phone:504-834-0378
Mailing Address - Fax:504-837-1652
Practice Address - Street 1:2633 NAPOLEON AVE
Practice Address - Street 2:STE 703
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6357
Practice Address - Country:US
Practice Address - Phone:504-897-6789
Practice Address - Fax:504-897-6790
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06185R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1901261Medicaid
LA1901261Medicaid
LA5M680Medicare ID - Type Unspecified