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NPI Code Detail

MEDICARE: ANTIMEDORA EMERLY JULIAN BACHELOR

MEDICARE:   ANTIMEDORA EMERLY JULIAN  BACHELOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114401924
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTIMEDORA EMERLY JULIAN BACHELOR
Provider Business Mailing Address
First Line : 3221 BEHRMAN PL STE 201
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114-8204
Country : US
Telephone Number : 504-263-2800
Fax Number : 504-263-2900
Provider Business Practice Location Address
First Line : 3221 BEHRMAN PL STE 201
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114-8204
Country : US
Telephone Number : 504-263-2800
Fax Number : 504-263-2900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2018
Last Update Date : 09/18/2018

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Directions to “ ANTIMEDORA EMERLY JULIAN BACHELOR” Practice Location

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