Healthcare Provider Details

I. General information

NPI: 1295735116
Provider Name (Legal Business Name): PADMINI NAGARAJ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3351 SEVERN AVE SUITE 301
METAIRIE LA
70002-7414
US

IV. Provider business mailing address

3351 SEVERN AVE SUITE 301
METAIRIE LA
70002-7414
US

V. Phone/Fax

Practice location:
  • Phone: 504-456-6065
  • Fax: 504-456-6067
Mailing address:
  • Phone: 504-456-6065
  • Fax: 504-456-6067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number06609R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number06609R
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number06609R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: