Healthcare Provider Details

I. General information

NPI: 1366856577
Provider Name (Legal Business Name): RODNEY PATTABHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 PERDIDO ST
NEW ORLEANS LA
70112-1352
US

IV. Provider business mailing address

2021 PERDIDO ST
NEW ORLEANS LA
70112-1352
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-2370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number305970
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: