Provider Demographics
NPI:1366492068
Name:BUSENLENER, TANYA SCHNELLER (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:SCHNELLER
Last Name:BUSENLENER
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 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:504-837-8293
Practice Address - Street 1:4901 VETERANS MEMORIAL BLVD.
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-5210
Practice Address - Country:US
Practice Address - Phone:504-887-1133
Practice Address - Fax:504-837-8293
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25555208000000X
LAMD.12215R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940534Medicaid
MS09277317Medicaid
LA1699705Medicaid
LA1940534Medicaid