Provider Demographics
NPI:1760445522
Name:ZAKRIS, ELLEN L (MD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:L
Last Name:ZAKRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELLEN
Other - Middle Name:LEVINE
Other - Last Name:ZAKRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3628
Mailing Address - Country:US
Mailing Address - Phone:504-897-7197
Mailing Address - Fax:
Practice Address - Street 1:1401 FOUCHER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3515
Practice Address - Country:US
Practice Address - Phone:504-897-8387
Practice Address - Fax:504-897-7778
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD09388R2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1950858Medicaid
F40013Medicare UPIN
LA5R308D913Medicare PIN
LA1950858Medicaid