Healthcare Provider Details
I. General information
NPI: 1447703103
Provider Name (Legal Business Name): JOSEPH GABRIEL SALIBA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/29/2016
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1401 JEFFERSON HWY
NEW ORLEANS LA
70121-2426
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-975-2160
- Fax:
- Phone: 504-842-3470
- Fax: 504-842-7372
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | 302953 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 329372 |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | DR.0068293 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: