Provider Demographics
NPI:1013108174
Name:GREIFFENSTEIN, PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:GREIFFENSTEIN
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 1:814 1/2 VALMONT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-1949
Mailing Address - Country:US
Mailing Address - Phone:504-722-1445
Mailing Address - Fax:
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAGETP.LSU.GS390200000X
LAMD.2023672086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1066711Medicaid
LACDS 038364-MDOtherCDS
LACDS 038364-MDOtherCDS