Advanced Neurodiagnostic Center, Inc
Organization Active NPI Neurology Physician · Metairie, LA
NPI 1164570883 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1164570883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- ADVANCED NEURODIAGNOSTIC CENTER, INC
- Practice address
- 2905 Kingman St
Metairie, LA 70006-6615 - Phone
- (504) 885-3737
- Fax
- (504) 885-5507
- NPI assigned
- Jan 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Simin Mirtaheri
- Title
- President
- Phone
- (504) 885-3737
Practitioners 4
-
John Kevin Jackson, M.D.
-
Jeannette Marie Lopez, M.D., PH.D.
-
Gian Carlo Gierbolini, M.D.
National Provider Directory
Locations
2905 Kingman St
Fl 2
Metairie, LA 70006
Phone (504) 885-3737
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | LA | Yes | |
| Psychiatry Physician |
2084P0800X | LA | ||
| Pain Medicine (Psychiatry & Neurology) Physician |
2084P2900X | 201074 | LA | |
| Sleep Medicine (Psychiatry & Neurology) Physician |
2084S0012X | LA | ||
| Diagnostic Radiology Physician |
2085R0202X | LA | ||
| Nurse Practitioner |
363L00000X | AP06242 | LA |
Addresses
Primary practice location
2905 Kingman St
Metairie, LA 70006-6615
Mailing address
2905 Kingman St FL 2
Metairie, LA 70006-6615
Phone (504) 885-3737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 548670743D | Other | LA | BLUE CROSS |
| 4391937610 | Other | LA | BCBS |
| 1946613 | Medicaid | LA | |
| 435707150C | Other | LA | BCBS |
| 767164775A | Other | LA | BCBS |
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All providers in Metairie, LA · Neurology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.