Ms Rita Boustany, MD | |
Pediatrix - 4600 Ambassador Caffery, Lafayette, LA 70508 | |
(337) 330-0031 | |
Not Available |
Full Name | Ms Rita Boustany |
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Gender | Female |
Speciality | Pediatrics |
Location | Pediatrix - 4600 Ambassador Caffery, Lafayette, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528183068 | NPI | - | NPPES |
2116436 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 37117 (Iowa) | Secondary |
208000000X | Pediatrics | MD.203808 (Louisiana) | Primary |
Entity Name | Pediatrix Emergent And Critical Care Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326278375 PECOS PAC ID: 0547309254 Enrollment ID: O20091209000039 |
Mailing Address | Practice Location Address |
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Ms Rita Boustany, MD Pediatrix - P.o. Box 60612, Lafayette, LA 70596-0612 Ph: (337) 330-0031 | Ms Rita Boustany, MD Pediatrix - 4600 Ambassador Caffery, Lafayette, LA 70508 Ph: (337) 330-0031 |
Dr. Sheung Man Alexander Sin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2390 W Congress St, Lafayette, LA 70506 Phone: 615-322-5000 | |
Karl M. Valcourt, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605 | |
Neva Ducote Seago, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Women's And Children's Hospital, Lafayette, LA 70508 Phone: 337-521-9100 | |
Dr. Colleen C Sicard, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Beaullieu Dr Ste 7, Lafayette, LA 70508 Phone: 337-366-8616 Fax: 337-366-8133 | |
Dr. Virginia B Coreil, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5000 Ambassador Caffery Pkwy Bldg 12, Lafayette, LA 70508 Phone: 337-470-3150 Fax: 337-470-3161 | |
Dr. Ebenezer S. Bediako, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-5500 Fax: 337-521-9166 | |
Mr. Cong T Vo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 107 Montrose Avenue, Suite D, Lafayette, LA 70503 Phone: 337-981-9316 Fax: 337-981-8303 |