Organization
CHILDREN'S HOSPITAL
Active
Parent organization
LOUISIANA CHILDREN'S MEDICAL CENTER
Other names
Manning Family Children's - Physician Billing
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUISIANA CHILDREN'S MEDICAL CENTER
Authorized official
MR. LUCIO FRAGOSO (CEO)
(504) 896-9511
Entity
Organization
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9511
(504) 896-2772
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9511
(504) 896-2772
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
174400000X
Specialist
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2080C0008X
Child Abuse Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134485
—
LA
Enumeration date
10/14/2010
Last updated
03/06/2025
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