Healthcare Provider Details

I. General information

NPI: 1841788023
Provider Name (Legal Business Name): SHAMSNIA NEUROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 KINGMAN ST 2ND AND 3RD FLOORS
METAIRIE LA
70006-6615
US

IV. Provider business mailing address

2909 KINGMAN ST 2ND AND 3RD FLOORS
METAIRIE LA
70006-6615
US

V. Phone/Fax

Practice location:
  • Phone: 504-717-2233
  • Fax:
Mailing address:
  • Phone: 504-717-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084D0003X
TaxonomyDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
License Number07451R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number07415R
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number07415R
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number07415R
License Number StateLA

VIII. Authorized Official

Name: JAMES JOSEPH LANDRY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 504-606-8164