Provider Demographics
NPI:1598747107
Name:MARKOWITZ, IRA P
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:P
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 PRYTANIA ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3500
Mailing Address - Country:US
Mailing Address - Phone:504-899-9800
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE 418
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-899-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017060174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09457064Medicaid
LA1357791Medicaid
LA230000396OtherRAILROAD MEDICARE
LA230000396OtherRAILROAD MEDICARE
LAB62838Medicare UPIN
LA51146Medicare PIN