Basic Information
| Provider Information | |||||||||
| NPI: | 1811183627 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTAGENA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | IVELISSE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4228 HOUMA BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700063004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044547878 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4228 HOUMA BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700063004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044547878 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2007 | ||||||||
| LastUpdateDate: | 09/15/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | GETP.EJGH.FP | LA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.