| Neuro Care Of Louisiana, Llc | |
|
648 Crestwood Blvd Covington LA 70433-6521 | |
| (985) 805-2555 | |
| (985) 400-5303 |
| Full Name | Neuro Care Of Louisiana, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 648 Crestwood Blvd, Covington, Louisiana |
| Authorized Official Name and Position | Ramy El Khoury (OWNER/DIRECTOR) |
| Authorized Official Contact | 9858052555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuro Care Of Louisiana, Llc 648 Crestwood Drive Covington LA 70433 Ph: (985) 805-2555 | Neuro Care Of Louisiana, Llc 648 Crestwood Blvd Covington LA 70433-6521 Ph: (985) 805-2555 |
| NPI Number | 1073962528 |
|---|---|
| Provider Enumeration Date | 06/06/2016 |
| Last Update Date | 07/24/2020 |
| Certification Date | 07/24/2020 |
| Medicare PECOS PAC ID | 0143514083 |
|---|---|
| Medicare Enrollment ID | O20160816000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073962528 | NPI | - | NPPES |
| 2324373 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Ramy El Khoury |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124380647 PECOS PAC ID: 5698911774 Enrollment ID: I20130416000114 |
| Provider Name | Steve Lee |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1699971465 PECOS PAC ID: 9739358250 Enrollment ID: I20140221000970 |
| Provider Name | Zachary J Liner |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1710203971 PECOS PAC ID: 1850686510 Enrollment ID: I20170623000979 |
| Provider Name | Alexis J Carimi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1194144345 PECOS PAC ID: 2567768997 Enrollment ID: I20181002001455 |
| Provider Name | Sabrina Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477107704 PECOS PAC ID: 3971833500 Enrollment ID: I20190925001275 |
| Provider Name | Tracy Aljabi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568092013 PECOS PAC ID: 4880023506 Enrollment ID: I20200401001376 |
| Provider Name | Nabil J Azar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972644391 PECOS PAC ID: 8325131675 Enrollment ID: I20200514000055 |
| Provider Name | Varun Kumar Pala |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154877405 PECOS PAC ID: 8628352374 Enrollment ID: I20210702000681 |
| Provider Name | Anila Kanna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538515200 PECOS PAC ID: 8820382831 Enrollment ID: I20210709001204 |
| Provider Name | Olga Gomez Siegert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427403989 PECOS PAC ID: 7810280799 Enrollment ID: I20210728000368 |
| Provider Name | Meagan Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447864491 PECOS PAC ID: 7012311129 Enrollment ID: I20210811004513 |
| Provider Name | Jennifer Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962177519 PECOS PAC ID: 3779972914 Enrollment ID: I20220519000159 |
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