Healthcare Provider Details

I. General information

NPI: 1982733648
Provider Name (Legal Business Name): MONA ADLY SHALABY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 GENERAL MEYER AVE SUITE 100
NEW ORLEANS LA
70131-3588
US

IV. Provider business mailing address

4008 TOLMAS DR
METAIRIE LA
70002-1851
US

V. Phone/Fax

Practice location:
  • Phone: 504-364-4066
  • Fax: 504-364-4077
Mailing address:
  • Phone: 504-421-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number07543R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: