Healthcare Provider Details

I. General information

NPI: 1679159107
Provider Name (Legal Business Name): ATIF GHAFFAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 TULANE AVE
NEW ORLEANS LA
70112-2865
US

IV. Provider business mailing address

1542 TULANE AVE RM 762
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4081
  • Fax:
Mailing address:
  • Phone: 504-568-4081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number337667
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number337667
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number337667
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: