Provider Demographics
NPI:1639190366
Name:KADISH, ROBERT JARRETT (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JARRETT
Last Name:KADISH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 N CAUSEWAY BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-4135
Mailing Address - Country:US
Mailing Address - Phone:504-833-0029
Mailing Address - Fax:504-833-0156
Practice Address - Street 1:1521 N CAUSEWAY BLVD
Practice Address - Street 2:STE. A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-4135
Practice Address - Country:US
Practice Address - Phone:504-833-0029
Practice Address - Fax:504-833-0156
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD183R213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAU64499Medicare UPIN
LA4250770001Medicare NSC