Healthcare Provider Details

I. General information

NPI: 1306723309
Provider Name (Legal Business Name): CARMEN TIJERINO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 JANET YULMAN WAY
NEW ORLEANS LA
70118-5671
US

IV. Provider business mailing address

612 GELPI AVE
JEFFERSON LA
70121-1528
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-8491
  • Fax:
Mailing address:
  • Phone: 985-215-7658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number09973
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: