Provider Demographics
NPI:1295735116
Name:NAGARAJ, PADMINI (MD)
Entity type:Individual
Prefix:DR
First Name:PADMINI
Middle Name:
Last Name:NAGARAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 SEVERN AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7414
Mailing Address - Country:US
Mailing Address - Phone:504-456-6065
Mailing Address - Fax:504-456-6067
Practice Address - Street 1:3351 SEVERN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7414
Practice Address - Country:US
Practice Address - Phone:504-456-6065
Practice Address - Fax:504-456-6067
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06609R2084F0202X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1366366Medicaid
LAB61772Medicare UPIN
LA5M328Medicare ID - Type Unspecified