Basic Information
Provider Information
NPI: 1861951014
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALKHAFAF
FirstName: QASIM
MiddleName: KADHIM
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1542 TULANE AVE FL 2
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701122865
CountryCode: US
TelephoneNumber: 5044121580
FaxNumber:  
Practice Location
Address1: 1542 TULANE AVE FL 2
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701122865
CountryCode: US
TelephoneNumber: 5044121580
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/18/2019
LastUpdateDate: 10/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X325993LAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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