Provider Demographics
NPI:1922271865
Name:AMERICAN BACK INSTITUTE OF GREATER NEW ORLEANS INC
Entity Type:Organization
Organization Name:AMERICAN BACK INSTITUTE OF GREATER NEW ORLEANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIZANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-833-2225
Mailing Address - Street 1:1920 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005
Mailing Address - Country:US
Mailing Address - Phone:504-833-2225
Mailing Address - Fax:504-834-1391
Practice Address - Street 1:2404 EDENBORN AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1817
Practice Address - Country:US
Practice Address - Phone:504-833-2225
Practice Address - Fax:504-832-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1957976Medicaid
LA436948276AOtherBC
LA1957976Medicaid
LAT20084Medicare UPIN