Provider Demographics
NPI:1689831299
Name:SIMONIAN, YURI (MD)
Entity Type:Individual
Prefix:MR
First Name:YURI
Middle Name:
Last Name:SIMONIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YURI
Other - Middle Name:
Other - Last Name:SIMANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1430 TULANE AVENUE
Mailing Address - Street 2:BOX 8611
Mailing Address - City:NEW ORLEASNS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-988-5217
Mailing Address - Fax:504-988-1846
Practice Address - Street 1:1430 TULANE AVENUE
Practice Address - Street 2:
Practice Address - City:NEW ORLEASNS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-988-5217
Practice Address - Fax:504-988-1846
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203622207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1453234Medicaid