Provider Demographics
NPI:1619267077
Name:TULANE INTERNAL MEDICINE
Entity Type:Organization
Organization Name:TULANE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. PROGRAM COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-988-7809
Mailing Address - Street 1:516 CLUB LN
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-7304
Mailing Address - Country:US
Mailing Address - Phone:410-832-8845
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # SL-50
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-1332
Practice Address - Fax:504-988-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital