Healthcare Provider Details

I. General information

NPI: 1063689966
Provider Name (Legal Business Name): TULANE SCHOOL DEPARTMENT OF PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2008
Last Update Date: 05/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 CANAL ST TB-53
NEW ORLEANS LA
70112-2703
US

IV. Provider business mailing address

1440 CANAL ST TB-53
NEW ORLEANS LA
70112-2703
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-4272
  • Fax:
Mailing address:
  • Phone: 504-988-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberGETP.TUL.P
License Number StateLA

VIII. Authorized Official

Name: DR. PATRICK T O' NEILL
Title or Position: ASSOC. PROF. OF CLINICAL PSYCHIATRY
Credential: MD
Phone: 504-988-4272