Healthcare Provider Details

I. General information

NPI: 1124023700
Provider Name (Legal Business Name): NEW ORLEANS HEADACHE & NEUROLOGY CLINIC, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MEADOWCREST ST STE 420
GRETNA LA
70056-5255
US

IV. Provider business mailing address

120 MEADOWCREST ST STE 420
GRETNA LA
70056-5255
US

V. Phone/Fax

Practice location:
  • Phone: 504-391-7547
  • Fax: 504-391-7549
Mailing address:
  • Phone: 504-391-7547
  • Fax: 504-391-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number05061R
License Number StateLA

VIII. Authorized Official

Name: DR. DHANPAT C MOHNOT
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 504-391-7547