Healthcare Provider Details

I. General information

NPI: 1497675458
Provider Name (Legal Business Name): MIDCITY PREMIER MEDICAL REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 BIENVILLE ST STE A
NEW ORLEANS LA
70119-5321
US

IV. Provider business mailing address

3400 BIENVILLE ST STE A
NEW ORLEANS LA
70119-5321
US

V. Phone/Fax

Practice location:
  • Phone: 504-488-3300
  • Fax: 504-486-0728
Mailing address:
  • Phone: 504-488-3300
  • Fax: 504-486-0728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MAI NGUYEN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 504-488-3300