Provider Demographics
NPI:1790052330
Name:INTERNAL MEDICINE ASSOCIATES OF NEW ORLEANS, LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF NEW ORLEANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARONGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-486-4201
Mailing Address - Street 1:618 N CARROLLTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-4707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:504-488-9659
Practice Address - Street 1:618 N CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-4707
Practice Address - Country:US
Practice Address - Phone:504-486-4201
Practice Address - Fax:504-488-9659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD011388207R00000X
LAMD011416207R00000X
LAMD014385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty