Healthcare Provider Details

I. General information

NPI: 1164559845
Provider Name (Legal Business Name): NAEEM & KUMAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 GAUSE BLVD E
SLIDELL LA
70461-4142
US

IV. Provider business mailing address

2375 GAUSE BLVD E
SLIDELL LA
70461-4142
US

V. Phone/Fax

Practice location:
  • Phone: 985-645-9000
  • Fax: 985-645-0359
Mailing address:
  • Phone: 985-645-9000
  • Fax: 985-645-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number94083008
License Number StateLA

VIII. Authorized Official

Name: MS. ANDREA ELIZABETH ALTAZAN
Title or Position: MANAGER
Credential:
Phone: 985-645-9000