Provider Demographics
NPI:1659699783
Name:JAISWAL, ABHISHEK (MD)
Entity Type:Individual
Prefix:
First Name:ABHISHEK
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 CANAL ST
Mailing Address - Street 2:APT 463
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2606
Mailing Address - Country:US
Mailing Address - Phone:504-988-1612
Mailing Address - Fax:
Practice Address - Street 1:1415 TULANE AVENUE
Practice Address - Street 2:TULANE MEDICAL CENTER
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-988-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD206818207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease