Healthcare Provider Details

I. General information

NPI: 1003313081
Provider Name (Legal Business Name): SEAN PATRICK BRADY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ESPLANADE AVE
KENNER LA
70065-2489
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2451
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3754
  • Fax: 504-842-6903
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number341576
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number011764
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: