1467721696 NPI number — SALEM ALI ASSIRI M.B.B.S

Table of content: SALEM ALI ASSIRI M.B.B.S (NPI 1467721696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467721696 NPI number — SALEM ALI ASSIRI M.B.B.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASSIRI
Provider First Name:
SALEM
Provider Middle Name:
ALI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.B.B.S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467721696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4345 CONNECTICUT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70065-1327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-842-3260
Provider Business Mailing Address Fax Number:
504-842-3193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1514 JEFFERSON HWY
Provider Second Line Business Practice Location Address:
BH 634
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70121-2429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-842-3260
Provider Business Practice Location Address Fax Number:
504-842-3193
Provider Enumeration Date:
12/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: INTERN . This is a "INTERN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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