Healthcare Provider Details

I. General information

NPI: 1528259660
Provider Name (Legal Business Name): ALLISON SIMON VITTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON SHERMAN SIMON

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1717 JEFFERSON AVE
NEW ORLEANS LA
70115-4915
US

V. Phone/Fax

Practice location:
  • Phone: 866-624-7637
  • Fax:
Mailing address:
  • Phone: 504-701-1837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMD.201615
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD.201615
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: