Healthcare Provider Details

I. General information

NPI: 1659886935
Provider Name (Legal Business Name): KREWE OF KIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W ROBERT E LEE BLVD STE 202
NEW ORLEANS LA
70124-2459
US

IV. Provider business mailing address

101 W ROBERT E LEE BLVD STE 202
NEW ORLEANS LA
70124-2459
US

V. Phone/Fax

Practice location:
  • Phone: 504-226-5739
  • Fax: 504-322-2695
Mailing address:
  • Phone: 504-226-5739
  • Fax: 504-322-2695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VERONICA GARIBALDI LEWIS
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: MD
Phone: 504-606-2098