Provider Demographics
NPI:1881726693
Name:CAROUSEL PEDIATRICS, APMC
Entity type:Organization
Organization Name:CAROUSEL PEDIATRICS, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-4141
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-885-4141
Mailing Address - Fax:504-456-8417
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-885-4141
Practice Address - Fax:504-456-8417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1199702Medicaid
LAG24407Medicare UPIN