Basic Information
| Provider Information | |||||||||
| NPI: | 1821319286 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | INTEGRATED BEHAVIORAL HEALTH | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | INTEGRATED BEHAVIORAL HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 POYDRAS ST | ||||||||
| Address2: | SUITE 1780 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701303245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043223837 | ||||||||
| FaxNumber: | 5043223847 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 POYDRAS ST | ||||||||
| Address2: | SUITE 1780 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701303245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043223837 | ||||||||
| FaxNumber: | 5043223847 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2010 | ||||||||
| LastUpdateDate: | 05/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | QALBANI | ||||||||
| AuthorizedOfficialFirstName: | MEHDI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 7734253750 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 202.425 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.