| Abdolreza Vadiee, Inc. | |
|
125 E Saint Bernard Hwy Chalmette LA 70043-5159 | |
| (504) 278-1414 | |
| (504) 278-1455 |
| Full Name | Abdolreza Vadiee, Inc. |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 125 E Saint Bernard Hwy, Chalmette, Louisiana |
| Authorized Official Name and Position | Abdolreza Vadiee (PRESIDENT) |
| Authorized Official Contact | 5042781414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abdolreza Vadiee, Inc. 125 E Saint Bernard Hwy Chalmette LA 70043-5159 Ph: (504) 278-1414 | Abdolreza Vadiee, Inc. 125 E Saint Bernard Hwy Chalmette LA 70043-5159 Ph: (504) 278-1414 |
| NPI Number | 1295790723 |
|---|---|
| Provider Enumeration Date | 04/18/2006 |
| Last Update Date | 10/31/2018 |
| Medicare PECOS PAC ID | 2365462611 |
|---|---|
| Medicare Enrollment ID | O20051201000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295790723 | NPI | - | NPPES |
| 1447617 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 023512 (Louisiana) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 023512 (Louisiana) | Primary |
| Provider Name | Abdolreza Vadiee |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1093770794 PECOS PAC ID: 0941216683 Enrollment ID: I20060306000115 |
| Provider Name | Carol Ann Vadiee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790740496 PECOS PAC ID: 0840208930 Enrollment ID: I20060331000151 |
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