Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 09014R | LA |
Y | 2080P0216X | Pediatric Rheumatologist | 09014R | LA |
NPI | 1538170055 |
---|---|
Provider Name | Mr. Abraham Gedalia |
First Address | New Orleans, LA 70118 |
Second Address | New Orleans, LA 70118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 19/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00110035 | (05) | LA |
00110035 | (05) | MS |
009960175 | (05) | AL |
1928453 | (05) | LA |
5N920 | (02) | LA |
F21976 | (02) |