Individual
ILANA S. FORTGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 MEDICAL CENTER BLVD., SUITE S-450, MARRERO, LA 70072
(504) 349-6401
(504) 349-6444
Mailing address
P.O. BOX 1520, MARRERO, LA 70073-1520
(504) 349-6423
(504) 934-8097
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
023358
LA
2080P0206X
Pediatric Gastroenterology Physician
Primary
MD.023358
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1499617
—
LA
Enumeration date
01/04/2007
Last updated
06/13/2016
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