Basic Information
| Provider Information | |||||||||
| NPI: | 1619221280 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WARREN EASTON SCHOOL-BASED HEALTH CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1430 TULANE AVE | ||||||||
| Address2: | TW22 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049882300 | ||||||||
| FaxNumber: | 5049883969 | ||||||||
| Practice Location | |||||||||
| Address1: | 3036 IBERVILLE ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049881840 | ||||||||
| FaxNumber: | 5049881841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2012 | ||||||||
| LastUpdateDate: | 11/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | REINA | ||||||||
| AuthorizedOfficialFirstName: | MARGARET | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 5049886821 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.