Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 328333 | LA |
NPI | 1023559275 |
---|---|
Provider Name | Elena Hart |
First Address | Metairie, LA 70003-1417 |
Second Address | River Ridge, LA 70123-6326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 20/08/2021 |