Provider Demographics
NPI:1932304094
Name:COENSON, CRAIG JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JEFFREY
Last Name:COENSON
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 1:1020 SAINT ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5022
Mailing Address - Country:US
Mailing Address - Phone:504-529-5558
Mailing Address - Fax:504-525-3235
Practice Address - Street 1:1020 SAINT ANDREW ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5022
Practice Address - Country:US
Practice Address - Phone:504-529-5558
Practice Address - Fax:504-525-3235
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0193082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1932304094OtherNPI
MN32663800Medicaid
LA1932304094OtherNPI