Healthcare Provider Details

I. General information

NPI: 1295262665
Provider Name (Legal Business Name): UDAY SHANKER NADIMPALLY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: UDAY SANKER NADIMPALLY

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date: 12/18/2017
Reactivation Date: 05/12/2018

III. Provider practice location address

2820 NAPOLEON AVE
NEW ORLEANS LA
70115-6969
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-894-2700
  • Fax: 504-842-3157
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number333981
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: