Healthcare Provider Details

I. General information

NPI: 1356854103
Provider Name (Legal Business Name): JENCARE NEIGHBORHOOD MEDICAL METAIRIE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JENCARE NEIGHBORHOOD MEDICAL CENTER UPTOWN 2820 NAPOLEON AVENUE, SUITE 590
NEW ORLEANS LA
70115
US

IV. Provider business mailing address

CHEN MEDICAL CORPORATE OFFICE 1395 N.W. 167TH STREET
MIAMI FL
33169
US

V. Phone/Fax

Practice location:
  • Phone: 305-628-6117
  • Fax: 305-363-5989
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND JIMENEZ
Title or Position: DIRECTOR CLIENT SVC
Credential:
Phone: 305-628-6117