Healthcare Provider Details

I. General information

NPI: 1770873275
Provider Name (Legal Business Name): SNEHA SAMANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4224 HOUMA BLVD STE 380 EJ PULM
METAIRIE LA
70006-2980
US

IV. Provider business mailing address

4224 HOUMA BLVD STE 380 EJ PULM
METAIRIE LA
70006-2980
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-5213
  • Fax: 504-456-8053
Mailing address:
  • Phone: 504-454-5213
  • Fax: 504-456-8053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number207432
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD.207432
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: