| Crescent City Headache And Neurology Center Llc | |
|
2116 Pakenham Dr Chalmette LA 70043-4722 | |
| (504) 301-1468 | |
| Not Available |
| Full Name | Crescent City Headache And Neurology Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2116 Pakenham Dr, Chalmette, Louisiana |
| Authorized Official Name and Position | Carol Redillas (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5049571766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent City Headache And Neurology Center Llc 2116 Pakenham Dr Chalmette LA 70043-4722 Ph: (504) 301-1468 | Crescent City Headache And Neurology Center Llc 2116 Pakenham Dr Chalmette LA 70043-4722 Ph: (504) 301-1468 |
| NPI Number | 1245572411 |
|---|---|
| Provider Enumeration Date | 03/26/2013 |
| Last Update Date | 05/25/2023 |
| Certification Date | 05/25/2023 |
| Medicare PECOS PAC ID | 3779722541 |
|---|---|
| Medicare Enrollment ID | O20130627000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245572411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 15249R (Louisiana) | Primary |
| Provider Name | Carol R Redillas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629023908 PECOS PAC ID: 8123915055 Enrollment ID: I20040303001225 |
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