Healthcare Provider Details

I. General information

NPI: 1568049237
Provider Name (Legal Business Name): VIVIAN R JABER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 TULANE AVE # T4M2
NEW ORLEANS LA
70112-2865
US

IV. Provider business mailing address

1542 TULANE AVE # T4M2
NEW ORLEANS LA
70112-2865
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-5600
  • Fax:
Mailing address:
  • Phone: 504-568-5600
  • 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 Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number348007
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: