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General NPI Number Information
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NPI Number | 1124075361
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Entity Type | Organization
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Legal Business Name | ST TAMMANY HEART & VASCULAR INSTITUTE
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 03/05/2011
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Provider Practice Location Address
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Address Line | 20 STARBRUSH CIR
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City | COVINGTON
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State | LA
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Zip | 70433-7208
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Country | US
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Telephone | 985-871-6020
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Fax | 985-898-7907
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Provider Business Mailing Address
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Address Line | PO BOX 62600 DEPT 1392
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City | NEW ORLEANS
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State | LA
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Zip | 70162-2600
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Country | US
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Telephone | 985-871-6020
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Fax | 985-871-6027
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. FARHAD X ADULI
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Credential | MD
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Telephone | 985-871-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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