MEDICARE: ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1700196193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND

Provider Business Mailing Address
First Line	:	1430 TULANE AVE
Second Line	:	TW22
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2632
Country	:	US
Telephone Number	:	504-988-2300
Fax Number	:	504-988-3969

Provider Business Practice Location Address
First Line	:	4626 ALCEE FORTIER BLVD
Second Line	:	SUITE D
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2130
Country	:	US
Telephone Number	:	504-255-8665
Fax Number	:	504-254-6447

Authorized Official
Title or Position	:	COO
Name	:	MS. MARGARET A REINA
Credential	:	AA
Telephone Number	:	504-988-6821

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	11/12/2010

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