Organization
NEW ORLEANS NEURO-RADIOSURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA M FORTUNATO (DIRECTOR)
(317) 536-1351
Entity
Organization
Contact information
Practice address
3434 PRYTANIA ST, SUITE 120, NEW ORLEANS, LA 70115-3532
(504) 891-2173
(504) 891-0147
Mailing address
3037 S MERIDIAN ST, INDIANAPOLIS, IN 46217-3227
(317) 536-1362
(317) 536-1363
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2203783118
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004123
STATE OF LOUISIANA
LA
Enumeration date
11/03/2016
Last updated
11/22/2021
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