Provider Demographics
NPI:1386835437
Name:SUS, RACHANA N (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHANA
Middle Name:N
Last Name:SUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHANA
Other - Middle Name:S
Other - Last Name:AMBARDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE # SL-16
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-1940
Mailing Address - Fax:504-988-8252
Practice Address - Street 1:4720 S I 10 SERVICE RD W
Practice Address - Street 2:SUITE 101
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7404
Practice Address - Country:US
Practice Address - Phone:504-988-8050
Practice Address - Fax:504-988-8051
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.202429207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07420235Medicaid
LA1091499Medicaid
LA1091499Medicaid
MS07420235Medicaid