Healthcare Provider Details

I. General information

NPI: 1386565026
Provider Name (Legal Business Name): ELIZABETH SHAYNE SCAFFIDI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 BOLIVAR ST
NEW ORLEANS LA
70112-7021
US

IV. Provider business mailing address

6104 COLBERT ST
NEW ORLEANS LA
70124-3011
US

V. Phone/Fax

Practice location:
  • Phone: 504-402-8555
  • Fax:
Mailing address:
  • Phone: 504-402-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: