Isfana J Ali, M.D.

Individual provider Active NPI Child & Adolescent Psychiatry Physician · Mandeville, LA

NPI 1154458248 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154458248
Entity type
Individual (NPI type 1)
Primary specialty
Child & Adolescent Psychiatry Physician 2084P0804X
License
013555 (LA)
Practice address
900 Wilkinson St
Mandeville, LA 70448-3533
Phone
(985) 624-4450
Fax
(985) 624-4461
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
013555LAMDChild & Adolescent Psychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 013555 LA Yes

Addresses

Primary practice location

900 Wilkinson St
Mandeville, LA 70448-3533

Mailing address

4210 Vincennes PL
New Orleans, LA 70125-2745
Phone (504) 861-2805

Other providers in Mandeville, LA

All providers in Mandeville, LA · Child & Adolescent Psychiatry Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.