MEDICARE: KIPP NEW ORLEANS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518365337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIPP NEW ORLEANS, INC.

Provider Business Mailing Address
First Line	:	1307 ORETHA CASTLE HALEY BLVD
Second Line	:	SUITE 302
City	:	NEW ORLEANS
State	:	LA
Zip	:	70113-1256
Country	:	US
Telephone Number	:	504-335-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 PIETY DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-2308
Country	:	US
Telephone Number	:	504-335-1935
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR OF FINANCE
Name	:	BRAD ROSENBLAT
Credential	:
Telephone Number	:	504-335-1935

Provider Enumeration Date	:	12/10/2014
Last Update Date	:	01/27/2017

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Directions to “KIPP NEW ORLEANS, INC. ” Practice Location

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