Provider Demographics
NPI:1184729303
Name:DELUDE, NEIL ALAN (PA-C)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:ALAN
Last Name:DELUDE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-885-6464
Mailing Address - Fax:504-885-8993
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:SUITE 21
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-885-6464
Practice Address - Fax:504-885-8993
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPAA10398RX363AM0700X
LAA10398RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57061P924Medicare PIN