Healthcare Provider Details

I. General information

NPI: 1669656344
Provider Name (Legal Business Name): TULANE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 TULANE AVE SL-37
NEW ORLEANS LA
70112-2632
US

IV. Provider business mailing address

1430 TULANE AVE SL-37
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5458
  • Fax:
Mailing address:
  • Phone: 504-988-5458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberGETP.TUL.PD
License Number StateLA

VIII. Authorized Official

Name: ALI SALAR KHALILI
Title or Position: RESIDENT
Credential: MD
Phone: 504-988-5458